scholarly journals Abrupt Intralesional Color Change on Dermoscopy as a New Indicator of Early Superficial Spreading Melanoma in a Japanese Woman

2015 ◽  
Vol 7 (2) ◽  
pp. 123-128 ◽  
Author(s):  
Anna Sadayasu ◽  
Masaru Tanaka ◽  
Yoshifumi Maumi ◽  
Eriko Ikeda ◽  
Mizuki Sawada ◽  
...  
Keyword(s):  
Color Change ◽  
Early Stage ◽  
Japanese Woman ◽  
Superficial Spreading ◽  
Superficial Spreading Melanoma ◽  
Old Japanese ◽  
S 100 ◽  
Histopathologic Findings ◽  
Black Pigmentation ◽  
Hmb 45

Diagnosis of superficial spreading melanoma in the early stage is often difficult, even with dermoscopy. We report the case of a 37-year-old Japanese woman with superficial spreading melanoma in her left buttock. The lesion developed 20 years before becoming visible and gradually enlarged over the past few years without any symptoms. Physical examination showed a well-demarcated dark-brown macule 10 mm in diameter. Dermoscopy demonstrated a central dark area with a blue-grey structureless area, a milky-red area with irregular blue-grey dots or globules suggestive of regression structures, and multifocal black pigmentation with whitish scaly areas. An abrupt intralesional change in color from a central dark area to a peripheral light-brown area was also seen. The peripheral area showed an atypical pigment network with an obscure mesh and holes. Histopathologic examination of the lesion showed acanthosis with melanocytic proliferation and nuclear atypia, a band-like lymphocytic infiltrate, melanophages and a few nests of melanocytes just beneath the epidermis. The epidermal melanocytes were positive for S-100, Melan-A and HMB-45, but the dermal nests of melanocytes were negative for HMB-45 and positive for S-100 and Melan-A. A diagnosis of superficial spreading melanoma with a tumor thickness of 0.4 mm (pT1aN0M0, stage 1A) was established based on the clinical, dermoscopic and histopathologic findings. This case suggests that dermoscopy is useful in the diagnosis of this condition. An abrupt intralesional change of color might be a new indicator of early superficial spreading melanoma.

scholarly journals Primary Amelanotic Rhabdoid Melanoma: A Case Report with Review of the Literature

2015 ◽  
Vol 7 (3) ◽  
pp. 292-297 ◽  
Author(s):  
Takahide Kaneko ◽  
Ayumi Korekawa ◽  
Eijiro Akasaka ◽  
Daiki Rokunohe ◽  
Hajime Nakano ◽  
...  
Keyword(s):  
Tumor Cells ◽  
Subsequent Treatment ◽  
Rare Entity ◽  
Rare Occurrence ◽  
Review Of The Literature ◽  
Cytoplasmic Inclusions ◽  
Pulmonary Alveoli ◽  
Old Japanese ◽  
S 100 ◽  
Hmb 45

Primary rhabdoid melanoma (PRM) is a rare variant of melanoma. Herein, we describe a case of primary amelanotic rhabdoid melanoma and review the clinicopathological features of previously reported cases of PRMs. A 63-year-old Japanese man presented with a nonpigmented red granular tumor without peripheral pigmented macules on the left heel measuring 21 × 18 mm in size. Light microscopic examination revealed a tumor mass composed entirely of polygonal neoplastic cells resembling pulmonary alveoli. Tumor cells were also discohesive with bizarre nuclei, prominent nucleoli and large hyaline cytoplasmic inclusions. No melanin pigment was present. Tumor cells were strongly and diffusely positive for S-100, MART-1, HMB-45 and vimentin, while negative for desmin, αSMA and synaptophysin. According to previous reviews, PRM tends to be amelanotic and nodular. S-100 protein and vimentin stained in all cases contrary to low stainability for HMB-45, which was, by contrast, positive in our case. Prognosis of PRM remains controversial due to the very rare occurrence of this tumor and the small number of confirmed cases that have been reported. Recognition of this rare entity is important in clinical practice even for skillful dermatologists to avoid misdiagnosis with the other tumors and to determinate the subsequent treatment principles.

scholarly journals Macular Hole Associated with Vogt-Koyanagi-Harada Disease at the Acute Uveitic Stage

2015 ◽  
Vol 6 (3) ◽  
pp. 328-332 ◽  
Author(s):  
Masaharu Mizuno ◽  
Kaoru Fujinami ◽  
Ken Watanabe ◽  
Kunihiko Akiyama
Keyword(s):  
Macular Hole ◽  
Early Stage ◽  
Japanese Woman ◽  
High Dose ◽  
Inner Limiting Membrane ◽  
Stage 4 ◽  
Old Japanese ◽  
Air Tamponade ◽  
Dose Corticosteroid ◽  
The Right

We describe a case with macular hole (MH) associated with Vogt-Koyanagi-Harada (VKH) disease. A 71-year-old Japanese woman presented with visual loss and headaches. The best-corrected visual acuity (BCVA) was 0.02 in the right eye (RE) and 0.1 in the left eye (LE). The patient was diagnosed with VKH based on circumferential choroidal detachments, multiple serous retinal detachments, and optic disc hyperemia. The multiple serous retinal detachments improved with high-dose corticosteroid therapy and gradual tapering. The BCVA was recovered to 1.2/0.7 in the RE/LE. Six weeks after the initial administration of steroid, vitreomacular traction was found by optical coherence tomography in the LE, which progressed to stage 4 MH with the BCVA of 0.2 in the LE. Twenty-three weeks after the initial treatment, vitrectomy was performed with the standard surgical procedures, including inner limiting membrane peeling around the fovea and air tamponade. The MH was closed successfully and the BCVA was 0.4 in the LE 5 weeks after the vitrectomy. This is the first report of a case with MH secondary to the acute uveitic stage of VKH. Successful closure of MH was achieved with the standard surgical intervention for an idiopathic MH. To conclude, at the early stage of VKH, there is a possibility of MH formation due to the rapid progress of vitreous traction following the inflammation, and the surgical procedure could be effective to resolve this secondary disorder.

scholarly journals Mucinous myoepithelioma: A report of a new variant

2020 ◽  
Vol 8 ◽  
pp. 2050313X2094056
Author(s):  
Xin Guo ◽  
Jiro Watanabe ◽  
Hiroaki Nakatani ◽  
Kei Fukushima ◽  
Sohsuke Yamada
Keyword(s):  
Parotid Gland ◽  
Needle Aspiration ◽  
Myoepithelial Cells ◽  
Japanese Woman ◽  
Biological Behavior ◽  
New Variant ◽  
Eosinophilic Cytoplasm ◽  
Old Japanese ◽  
S 100 ◽  
The Right

Myoepitheliomas account for approximately 1.5% of all salivary gland tumors and arise most frequently from the parotid gland. Recently, a new myoepithelioma variant, called mucinous myoepithelioma, has attracted widespread attention. These tumors are recognized as a unique subtype of myoepithelioma, characterized by the presence of abundant mucin. We herein report the findings of an 86-year-old Japanese woman who presented with a hard mass of the right parotid gland behind her right ear which was gradually increasing in size. The patient had undergone a fine-needle aspiration biopsy 4 years earlier, and a cytological evaluation of a biopsy specimen had shown features of pleomorphic adenoma. A resection was thus performed and the tissue was found to be an encapsulated, soft and solid mass, and the cut surface was observed to be a capsulated and well-defined tumor lesion with myxoid-looking foci of gray-white coloration. Microscopic examination revealed that this lesion was composed of a proliferation of bland-looking epithelial and myoepithelial cells, arranged in a solid or reticular growth fashion in an abundant myxomatous or hyalinized stroma. These neoplastic epithelial cells had centrally located small nuclei with fine chromatin and abundant clear to eosinophilic cytoplasm, often containing mucin in a uniform pattern. Immunohistochemical staining demonstrated the tumor cells to be positive for AE1/AE3, S-100 and mucicarmine. Our findings suggest this case to be one myoepithelioma variant of mucinous myoepithelioma, and more experience related to this myoepithelioma variant is necessary to better understand its biological behavior and make an accurate diagnosis for a proper treatment.

scholarly journals Neuroendocrine carcinoma arising in a wound of the postoperative maxillary sinus

2012 ◽  
Vol 2 (1) ◽  
pp. 16
Author(s):  
Takeshi Kusunoki ◽  
Katsuhisa Ikeda
Keyword(s):  
Maxillary Sinus ◽  
Neuroendocrine Carcinoma ◽  
Past History ◽  
Japanese Woman ◽  
Old Japanese ◽  
Weighted Magnetic Resonance Imaging ◽  
Maxillary Cyst ◽  
Left Maxillary Sinus ◽  
Eye Movement Disorders ◽  
Cheek Swelling

We report a case of a neuroendocrine carcinoma arising in a wound of the postoperative maxillary sinus that was difficult to distinguish from a postoperative maxillary cyst. The patient was a 65-year-old Japanese woman who complained of left exophthalmos with cheek swelling and eye movement disorders. In past history, she had, 40 years previously undergone operation on the bilateral maxillary sinus by Caldwell-Luc’s method. In a preoperative computed tomography, a mass occupied the left maxillary sinus showing irregular densities with destruction of the posterior bone walls and invasion into the left orbital. Both TI and T2 weighted magnetic resonance imaging showed low intensities and unevenness in the mass. We performed a biopsy of the maxillary tumor according to Caldwell-Luc’s method. Histological examination diagnosed neuroendocrine carcinoma. Radiation therapy (total 66Gy) resulted in partial response for this tumor. However, sinonasal neuroendocrine carcinoma has been identified as highly aggressive, with a high probability of recurrence and metastasis.

scholarly journals Severe infection including disseminated herpes zoster triggered by subclinical Cushing’s disease: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuki Yamauchi ◽  
Hiraku Kameda ◽  
Kazuno Omori ◽  
Michio Tani ◽  
Kyu Yong Cho ◽  
...  
Keyword(s):  
Herpes Zoster ◽  
Cushing’S Disease ◽  
Cardiopulmonary Arrest ◽  
Severe Infection ◽  
Japanese Woman ◽  
The Body ◽  
Cushing's Disease ◽  
Old Japanese ◽  
Subclinical Cushing’S Disease ◽  
Physical Features

Abstract Background Subclinical Cushing’s disease (SCD) is defined by corticotroph adenoma-induced mild hypercortisolism without typical physical features of Cushing’s disease. Infection is an important complication associated with mortality in Cushing’s disease, while no reports on infection in SCD are available. To make clinicians aware of the risk of infection in SCD, we report a case of SCD with disseminated herpes zoster (DHZ) with the mortal outcome. Case presentation An 83-year-old Japanese woman was diagnosed with SCD, treated with cabergoline in the outpatient. She was hospitalized for acute pyelonephritis, and her fever gradually resolved with antibiotics. However, herpes zoster appeared on her chest, and the eruptions rapidly spread over the body. She suddenly went into cardiopulmonary arrest and died. Autopsy demonstrated adrenocorticotropic hormone-positive pituitary adenoma, renal abscess, and DHZ. Conclusions As immunosuppression caused by SCD may be one of the triggers of severe infection, the patients with SCD should be assessed not only for the metabolic but also for the immunodeficient status.

scholarly journals Evolution of superficial spreading melanoma to resemble desmoplastic melanoma: case report

2021 ◽  
Author(s):  
Martin G. Cook ◽  
Barry W. E. M. Powell ◽  
Megan E. Grant ◽  
Adele C. Green
Keyword(s):  
Case Report ◽  
Clinical Management ◽  
Unusual Case ◽  
Primary Site ◽  
Mixed Tumor ◽  
Superficial Spreading ◽  
Superficial Spreading Melanoma ◽  
Desmoplastic Melanoma ◽  
Mixed Features ◽  
Melanoma Case

AbstractDesmoplastic melanoma commonly occurs on the head and neck in a pure form, but occasionally, it occurs in a mixed tumor with another type, usually superficial spreading melanoma (SSM), and rarely as a metastasis from a primary SSM. We report here a primary SSM on the leg of a 32-year-old male which metastasised to lymph nodes, and 10 years later recurred at the primary site initially with mixed features but evolving to resemble a uniformly desmoplastic, deeply invasive melanoma. This unusual case has implications for clinical management and is additionally notable for its reversal in behavior, from metastatic to local infiltrative type, correlating with the change in morphology.

scholarly journals Cutaneous Melanomas Arising during Childhood: An Overview of the Main Entities

2021 ◽  
Vol 8 (3) ◽  
pp. 301-314
Author(s):  
Arnaud de la Fouchardière ◽  
Felix Boivin ◽  
Heather C. Etchevers ◽  
Nicolas Macagno
Keyword(s):  
Lymph Node ◽  
Regional Lymph Node ◽  
Germline Mutations ◽  
Epithelioid Cells ◽  
Superficial Spreading ◽  
Superficial Spreading Melanoma ◽  
Cancer Predisposition Syndrome ◽  
Specific Morphology ◽  
Genetic Features ◽  
Molecular Assessment

Cutaneous melanomas are exceptional in children and represent a variety of clinical situations, each with a different prognosis. In congenital nevi, the risk of transformation is correlated with the size of the nevus. The most frequent type is lateral transformation, extremely rare before puberty, reminiscent of a superficial spreading melanoma (SSM) ex-nevus. Deep nodular transformation is much rarer, can occur before puberty, and must be distinguished from benign proliferative nodules. Superficial spreading melanoma can also arise within small nevi, which were not visible at birth, usually after puberty, and can reveal a cancer predisposition syndrome (CDKN2A or CDK4 germline mutations). Prognosis is correlated with classical histoprognostic features (mainly Breslow thickness). Spitz tumors are frequent in adolescents and encompass benign (Spitz nevus), intermediate (atypical Spitz tumor), and malignant forms (malignant Spitz tumor). The whole spectrum is characterized by specific morphology with spindled and epithelioid cells, genetic features, and an overall favorable outcome even if a regional lymph node is involved. Nevoid melanomas are rare and difficult to diagnose clinically and histologically. They can arise in late adolescence. Their prognosis is currently not very well ascertained. A small group of melanomas remains unclassified after histological and molecular assessment.

scholarly journals Conservatively Treated Femoral Intertrochanteric Fracture With Early Asymptomatic Novel Coronavirus Disease 2019 (COVID-19): A Case Report

2020 ◽  
Vol 11 ◽  
pp. 215145932096938
Author(s):  
Yuki Suzuki ◽  
Toshihiko Kasashima ◽  
Kazutoshi Hontani ◽  
Yasuhiro Yamamoto ◽  
Kanako Ito ◽  
...  
Keyword(s):  
Intertrochanteric Fracture ◽  
Screening Method ◽  
Oxygen Demand ◽  
Japanese Woman ◽  
Trauma Patients ◽  
Lung Field ◽  
Old Japanese ◽  
Femoral Intertrochanteric Fracture ◽  
Novel Coronavirus ◽  
The Right

Introduction: The ongoing outbreak of novel coronavirus disease 2019 (COVID-19) is a worldwide problem. Although diagnosing COVID-19 in fracture patients is important for selecting treatment, diagnosing early asymptomatic COVID-19 is difficult. We describe herein a rare case of femoral intertrochanteric fracture concomitant with early asymptomatic novel COVID-19. Case presentation: An 87-year-old Japanese woman was transferred to our emergency room with a right hip pain after she fell. She had no fever, fatigue, or respiratory symptoms on admission and within the 14 days before presenting to our hospital, and no specific shadow was detected in chest X-ray. However, chest computed tomography (CT) was performed considering COVID-19 pandemic, and showed ground-glass opacities with consolidation in the dorsal segment of the right lower lung field. Then, qualitative real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) was carried out and turned out to be positive. She was diagnosed right femoral intertrochanteric fracture with concomitant COVID-19 infection. Conservative treatment was applied to the fracture due to infection. After admission, fever and oxygen demand occurred but she recovered from COVID-19. Throughout the treatment period, no cross-infection from the patient was identified in our hospital. Conclusion: This case highlights the importance of considering chest CT as an effective screening method for infection on hospital admission in COVID-19-affected areas, especially in trauma patients with early asymptomatic novel COVID-19.

Rapid Deterioration of Latent HBV Hepatitis during Cushing Disease and Posttraumatic Stress Disorder after Earthquake

2017 ◽  
Vol 78 (04) ◽  
pp. 407-411 ◽  
Author(s):  
Ryosuke Tashiro ◽  
Teiji Tominaga ◽  
Yoshikazu Ogawa
Keyword(s):  
Hepatic Dysfunction ◽  
Residual Tumor ◽  
Optic Chiasm ◽  
Japanese Woman ◽  
Hbv Reactivation ◽  
Cushing Disease ◽  
Old Japanese ◽  
Threatening Condition ◽  
The Right ◽  
Subtotal Removal

AbstractReactivation of the hepatitis B virus (HBV) is a risk in the 350 million HBV carriers worldwide. HBV reactivation may cause hepatocellular carcinoma, cirrhosis, and fulminant hepatitis, and HBV reactivation accompanied with malignant tumor and/or chemotherapy is a critical problem for patients with chronic HBV infection. Multiple risk factors causing an immunosuppressive state can also induce HBV reactivation.We present a case of HBV reactivation during an immunosuppressive state caused by Cushing disease and physical and psychological stress after a disaster. A 47-year-old Japanese woman was an inactive HBV carrier until the Great East Japan Earthquake occurred and follow-up was discontinued. One year after the earthquake she had intractable hypertension, and her visual acuity gradually worsened. Head magnetic resonance imaging showed a sellar tumor compressing the optic chiasm, and hepatic dysfunction with HBV reactivation was identified. Endocrinologic examination established the diagnosis as Cushing disease. After normalization of hepatic dysfunction with antiviral therapy, transsphenoidal tumor removal was performed that resulted in subtotal removal except the right cavernous portion. Steroid hormone supplementation was discontinued after 3 days of administration, and gamma knife therapy was performed for the residual tumor. Eighteen months after the operation, adrenocorticotropic hormone and cortisol values returned to normal. The patient has been free from tumor regrowth and HBV reactivation throughout the postoperative course.Accomplishment of normalization with intrinsic steroid value with minimization of steroid supplementation should be established. Precise operative procedures and careful treatment planning are essential to avoid HBV reactivation in patients with this threatening condition.

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