Tumoral melanosis involving the sentinel lymph nodes: A case report
ABSTRACT Tumoral or nodular melanosis is characterized by a clinical lesion suspicious for malignant melanoma, the histopathological correlate is a nodular accumulation of melanophages in the dermis. We present a patient with nodular melanosis involving also the sentinel lymph nodes and discuss possible differential diagnoses as well as prognostic and therapeutic implications.
Article: Prognostic models in melanoma.[Show abstract] [Hide abstract]
ABSTRACT: Predicting which patients with primary melanoma are at risk of developing metastastic disease is important for making rational therapeutic decisions. Tumor thickness alone is the most commonly used predictor of survival, but other clinical and pathologic variables also play an important role. We have developed two multivariate logistic regression models to predict survival in patients who have primary melanoma. The first of these models assigns patients to two groups based on radial or vertical growth phase. The probability of survival for those patients with vertical growth phase tumors was further determined based on a model using six variables (mitotic rate, tumor infiltrating lymphocytes, tumor thickness, anatomic site of the primary tumor, sex, and histologic regression) that have the greatest strength as independent predictors of survival. This model is 89% accurate for predicting survival in patients with vertical growth phase tumors. A second model has been developed that uses readily available clinical parameters to predict survival. Four variables (tumor thickness, anatomic site, age, and sex) entered into the model as powerful independent predictors. Clinical algorithms for assessing patient risk are provided.Seminars in Oncology 03/1997; 24(1 Suppl 4):S2-7. · 3.94 Impact Factor
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ABSTRACT: We present an extremely rare case of an orbital melanocytoma that occurred in a 51-year-old man. The patient suffered from diplopia and mild exophthalmos of the right eye for 2 months. Brain magnetic resonance imaging showed a well-demarcated round mass 3.5 cm in diameter in the right orbit. We performed total resection of this tumor. Histological findings revealed a proliferation of large polygonal cells with fine pigment granules in the cytoplasm and prominent nucleoli. Although these tumor cells revealed immunohistochemical reactivity in HMB-1, there was no S-100 or Melan A antibody reactivity. Also, there were no malignant findings of nuclear polymorphism, mitoses, or necrosis. The brown pigments were confirmed to be melanin by bleaching and the Fontana-Masson silver stain method. The MIB-1 labeling index was less than 1%. This tumor also consisted of 50% melanophages, which revealed immunohistochemical reactivity in CD68, CD163, and in (1-AT antibodies. These histological findings led us to diagnose an orbital melanocytoma with partial tumor regression.Brain Tumor Pathology 02/2009; 26(1):25-9. DOI:10.1007/s10014-008-0242-8 · 2.28 Impact Factor
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ABSTRACT: Tumoral or nodular melanosis in the skin is considered a variation of completely regressed melanoma, presenting clinically as a suspicious pigmented papule or nodule. Microscopically, the lesion consists of a nodular accumulation of heavily pigmented melanophages in the dermis, staining positive for immunohistochemical markers of histiocytic lineage (CD68) and negative for those of melanocytic lineage (S100, HMB-45, Melan-A). This process is rarely described in lymph nodes. We present a report of a patient with melanosis involving multiple lymph nodes of an axillary dissection, done for metastatic melanoma with an unknown primary, and discuss possible prognostic and treatment factors.Archives of pathology & laboratory medicine 09/2009; 133(8):1332-4. DOI:10.1043/1543-2165-133.8.1332 · 2.88 Impact Factor