scholarly journals Conjunctival Melanoma Angiotropic Microsatellitosis: A Mechanism of Local Extravascular Migratory Metastasis

2020 ◽  
Vol 6 (4) ◽  
pp. 287-292
Author(s):  
Jose J. Echegaray ◽  
Gabrielle Yeaney ◽  
Rachel Chen ◽  
Arun D. Singh
Keyword(s):  
Local Recurrence ◽  
Tumor Cells ◽  
Tumor Staging ◽  
Retrospective Chart Review ◽  
Conjunctival Melanoma ◽  
Melanoma Tumor ◽  
Primary Tumor Site ◽  
Primary Acquired Melanosis ◽  
Local Metastasis ◽  
Related Mortality

Purpose: To report a case of local metastasis of conjunctival melanoma, which may occur via extravascular migratory metastasis (EVMM), and discuss its clinical relevance in conjunctival melanoma tumor staging and possible management implications. Methods: Retrospective chart review of a single clinical case with clinicopathologic correlation. Results: A 65-year-old male referred due to local recurrence of conjunctival melanoma at the caruncle was successfully treated after two excisional procedures with negative sentinel lymph node biopsies. Forty-eight months after initial presentation, the patient developed a nodular lesion representing local recurrence in the ipsilateral upper tarsal conjunctiva, distant from the primary tumor site. Histopathology showed nodules in the substantia propria in the absence of primary acquired melanosis. The tumor cells were found along the extravascular surface without intralymphatic or intravascular tumor cells consistent with local metastasis. One possible mechanism is angiotropic microsatellitosis leading to local EVMM. Additional neck CT imaging showed no lymphadenopathy. Conclusion: EVMM via angiotropic microsatellitosis is another possible mechanism of noncontiguous local recurrence of conjunctival melanoma. Angiotropic microsatellitosis may represent a high-risk finding possibly related to increased melanoma-related mortality.

scholarly journals Two Late Recurrences of Conjunctival Melanoma

2018 ◽  
Vol 5 (4) ◽  
pp. 262-266 ◽  
Author(s):  
Niels J. Brouwer ◽  
Stijn W. Genders ◽  
Marina Marinkovic ◽  
Sjoerd G. van Duinen ◽  
Martine J. Jager ◽  
...  
Keyword(s):  
Tumor Cells ◽  
Surgical Procedures ◽  
Histopathological Examination ◽  
Orbital Exenteration ◽  
Conjunctival Melanoma ◽  
Inferior Margin ◽  
Primary Acquired Melanosis ◽  
The Right ◽  
Additional Therapy

Purpose: To report a patient who developed two late recurrences of conjunctival melanoma (CoM), of which one occurred after orbital exenteration. Methods: We describe the case of a patient based on clinical and histopathological examination. Results: A 52-year-old patient was treated with local excision and cryotherapy for a CoM with primary acquired melanosis (PAM) near the limbus of the right eye. Twenty-one years later, a recurrence developed in the superior fornix of the same eye in an area with widespread PAM; an orbital exenteration was performed. After another 4 years, a painful nodule developed subcutaneously at the inferior margin of the right orbital socket. Pathology showed a recurrence of CoM with a BRAF V600K mutation, similar to both of the previous lesions (of 25 and 4 years earlier). The nodule was excised without additional therapy. No recurrences or metastases have been observed in the next 2.5 years. The proposed mechanism for the recurrence after surgery could be via dormant tumor cells that have spread prior to the procedure or via residual intraepithelial malignant melanocytes. Conclusion: Very late recurrences of CoM are rare but may occur. Our case illustrates the need for long-term awareness of doctors and patients, even after extensive surgical procedures such as orbital exenteration.

scholarly journals Conjunctival melanoma treatment outcomes in 288 patients: a multicentre international data-sharing study

2020 ◽  
pp. bjophthalmol-2020-316293
Author(s):  
Puneet Jain ◽  
Paul T Finger ◽  
Maria Fili ◽  
Bertil Damato ◽  
Sarah E Coupland ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Local Excision ◽  
External Beam Radiotherapy ◽  
Staging System ◽  
Primary Treatment ◽  
Excision Biopsy ◽  
Conjunctival Melanoma ◽  
Recurrence Rates ◽  
Increased Risk ◽  
Eighth Edition

BackgroundTo relate conjunctival melanoma characteristics to local control.MethodsRetrospective, registry-based interventional study with data gathered from 10 ophthalmic oncology centres from 9 countries on 4 continents. Conjunctival melanoma patients diagnosed between January 2001 and December 2013 were enrolled in the study. Primary treatments included local excision, excision with cryotherapy and exenteration. Adjuvant treatments included topical chemotherapy, brachytherapy, proton and external beam radiotherapy (EBRT). Cumulative 5-year and 10-year Kaplan-Meier local recurrence rates were related to clinical and pathological T-categories of the eighth edition of the American Joint Committee on Cancer (AJCC) staging system.Results288 patients had a mean initial age of 59.7±16.8 years. Clinical T-categories (cT) were cT1 (n=218,75.7%), cT2 (n=34, 11.8%), cT3 (n=15, 5.2%), cTx (n=21,7.3%) with no cT4. Primary treatment included local excision (n=161/288, 55.9%) followed by excision biopsy with cryotherapy (n=108/288, 37.5%) and exenteration (n=5/288, 1.7%). Adjuvant therapies included topical mitomycin (n=107/288, 37.1%), plaque-brachytherapy (n=55/288, 19.1%), proton-beam (n=36/288, 13.5%), topical interferon (n=20/288, 6.9%) and EBRT (n=15/288, 5.2%). Secondary exenteration was performed (n=11/283, 3.9%). Local recurrence was noted in 19.1% (median=3.6 years). Cumulative local recurrence was 5.4% (3.2–8.9%), 19.3% (14.4–25.5%) and 36.9% (26.5–49.9%) at 1, 5 and 10 years, respectively. cT3 and cT2 tumors were twice as likely to recur than cT1 tumours, but only cT3 had statistically significantly greater risk of local recurrence than T1 (p=0.013). Factors such as tumour ulceration, plica or caruncle involvement and tumour thickness were not significantly associated with an increased risk of local recurrence.ConclusionThis multicentre international study showed that eighth edition of AJCC tumour staging was related to the risk of local recurrence of conjunctival melanoma after treatment. The 10-year cumulative local recurrence remains high despite current management.

Tumor Regression Grading After Preoperative Chemoradiotherapy for Locally Advanced Rectal Carcinoma Revisited: Updated Results of the CAO/ARO/AIO-94 Trial

2014 ◽  
Vol 32 (15) ◽  
pp. 1554-1562 ◽  
Author(s):  
Emmanouil Fokas ◽  
Torsten Liersch ◽  
Rainer Fietkau ◽  
Werner Hohenberger ◽  
Tim Beissbarth ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Tumor Cells ◽  
Rectal Carcinoma ◽  
Distant Metastasis ◽  
Cumulative Incidence ◽  
Tumor Regression ◽  
Preoperative Chemoradiotherapy ◽  
Regression Grading ◽  
Clinicopathologic Parameters

Purpose We previously described the prognostic impact of tumor regression grading (TRG) on the outcome of patients with rectal carcinoma treated with preoperative chemoradiotherapy (CRT) in the CAO/ARO/AIO-94 trial. Here we report long-term results after a median follow-up of 132 months. Patients and Methods TRG after preoperative CRT was determined in 386 surgical specimens by the amount of viable tumor cells versus fibrosis, ranging from TRG 4 (no viable tumor cells) to TRG 0 (no signs of regression). Clinicopathologic parameters and TRG were correlated to the cumulative incidence of local recurrence, distant metastasis, and disease-free survival (DFS). Results Ten-year cumulative incidence of distant metastasis and DFS were 10.5% and 89.5% for patients with TRG 4 (complete regression), 29.3% and 73.6% for TRG 2 and 3 (intermediate regression), and 39.6% and 63% for TRG 0 and 1 (poor regression), respectively (P = .005 and P = .008, respectively). On multivariable analysis, residual lymph node metastasis (ypN+) and TRG were the only independent prognostic factors for cumulative incidence of distant metastasis (P < .001 and P = .035, respectively) and DFS (P < .001 and P = .039, respectively), whereas local recurrence was significantly affected by ypN status (P < .001) and lymphatic invasion (P = .026). Conclusion Complete and intermediate tumor regressions were associated with improved long-term outcome in patients with rectal carcinoma after preoperative CRT independent of clinicopathologic parameters. This classification system needs to be prospectively tested in multiple data sets to validate its reproducibility in a wider setting.

scholarly journals Intravascular neoplastic cells in canine cutaneous plasmacytomas

2018 ◽  
Vol 30 (2) ◽  
pp. 329-332 ◽  
Author(s):  
Gordon Ehrensing ◽  
Linden E. Craig
Keyword(s):  
Endothelial Cells ◽  
Local Recurrence ◽  
Light Microscopy ◽  
Tumor Cells ◽  
Prognostic Significance ◽  
Neoplastic Cells ◽  
Surgical Biopsy ◽  
University Of Tennessee ◽  
The University

We evaluated 134 cutaneous plasmacytomas in 125 dogs submitted to the University of Tennessee surgical biopsy service between 2009 and 2012 to determine whether the presence of intravascular neoplastic cells had prognostic significance. Tumors occurred in middle-aged to geriatric dogs (range: 5–16 y, mean: 9.6 y) and most frequently involved the skin of the head and distal limbs. Diagnoses were made based on light microscopy, and in some cases confirmed by immunoreactivity of neoplastic cells for MUM1. Tumors were categorized as having or not having intravascular neoplastic cells within sections examined. The intravascular location of tumor cells was confirmed by immunoreactivity of endothelial cells for factor VIII–related antigen in 3 cases. Neoplastic cells within vessel lumens were identified in 20 of 125 dogs (16%). Submitting veterinary practices were contacted for follow-up data on patients including local recurrence and cutaneous plasmacytomas in other locations. Follow-up information was acquired on 99 dogs (79%). Recurrence was documented in one dog with cutaneous plasmacytomas; both masses had incomplete margins and intravascular neoplastic cells. Additional distant cutaneous plasmacytomas were later diagnosed in 3 patients; none of these dogs had intravascular neoplastic cells. In no cases were cutaneous plasmacytomas suspected to be a cause of death or reason for euthanasia. Intravascular neoplastic cells were more common in tumors of the distal limbs (36%) compared to other locations (11%; p = 0.0007). The presence of intravascular neoplastic cells did not affect prognosis in cutaneous plasmacytomas.

scholarly journals Differential Characteristics and Prognosis of PD-L1–Positive Endometrial Carcinomas: A Retrospective Chart Review

Life ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1047
Author(s):  
Justin Z. Amarin ◽  
Razan Mansour ◽  
Sura Al-Ghnimat ◽  
Maysa Al-Hussaini
Keyword(s):  
Overall Survival ◽  
Tumor Cells ◽  
Chart Review ◽  
Prognostic Significance ◽  
Retrospective Chart Review ◽  
Cancer Center ◽  
High Grade ◽  
Endometrial Carcinomas

Women with endometrial carcinomas that express PD-L1 may respond better to immunotherapy. Our aim was to investigate the differential characteristics of PDL1–positive endometrial carcinomas and the prognostic significance of PDL1. We performed a retrospective chart review of 231 women with endometrial carcinomas who were managed at King Hussein Cancer Center (2007–2016) and performed immunohistochemistry for MLH1, PMS2, MSH2, MSH6, p53, and PD-L1. Overall, 89 cases (38.5%) were MMR-deficient. PD-L1 was expressed in 49 cases (21.2%) and its expression was significantly associated with MLH1/PMS2 deficiency (p = 0.044) but not MSH2/MSH6 deficiency (p = 0.59). p53 was mutant in 106 cases (46.5%), and its mutation was significantly associated with MMR proficiency (p < 0.001) but not PDL1 expression (p = 0.78). In women with endometrioid adenocarcinomas, PD-L1 expression was significantly associated with the Fédération Internationale de Gynécologie et d'Obstétrique (FIGO) grade (p = 0.008). Overall, PDL1 expression did not significantly predict overall survival in unadjusted or adjusted analyses (p = 0.92 and 0.54, respectively). In conclusion, tumors with MLH1/PMS2 loss and high-grade endometrioid adenocarcinomas were more likely to express PDL1 in tumor cells. Further research is required to investigate whether the presence of either characteristic signals a higher likelihood of a favorable response if immunotherapy is administered.

Malignant Melanoma With a Rhabdoid Phenotype: Histologic, Immunohistochemical, and Ultrastructural Study of a Case and Review of the Literature

2004 ◽  
Vol 128 (6) ◽  
pp. 686-688
Author(s):  
Jared J. Abbott ◽  
Robin H. Amirkhan ◽  
Mai P. Hoang
Keyword(s):  
Malignant Melanoma ◽  
Tumor Cells ◽  
Rare Variant ◽  
Smooth Muscle Actin ◽  
S100 Protein ◽  
Metastatic Lesion ◽  
Primary Tumor Site ◽  
Cytoplasmic Inclusions ◽  
Rhabdoid Cells ◽  
Rhabdoid Tumors

Abstract Malignant melanoma is known to display tremendous histologic diversity. One rare variant is the rhabdoid phenotype, so called because of the appearance of cells resembling rhabdomyoblasts seen in malignant rhabdoid tumors of the kidney. We present the histologic, immunohistochemical, and ultrastructural features of a malignant melanoma composed entirely of rhabdoid cells. A 62-year-old man presented with a 6.5-cm lung mass. Although presumed to be a metastatic lesion, extensive workup failed to reveal a primary tumor site. Histologic sections showed a mass composed entirely of polygonal neoplastic cells with prominent nucleoli and large hyaline cytoplasmic inclusions. The tumor cells were strongly immunoreactive with S100 protein, vimentin, and CD56, and were focally reactive with Mart-1. Tumor cells were negative for Melan-A, tyrosinase, HMB-45, AE1/AE3, cytokeratin (CK) 7, CK8/ 18, CK20, CK903, CAM 5.2, epithelial membrane antigen, smooth muscle actin, desmin, leukocyte common antigen, Bcl-2, CD3, CD20, CD30, CD138, κ and λ light chains, CD68, CD34, factor VIII, synaptophysin, and glial fibrillary acidic protein. Electron microscopy showed cytoplasmic whorls of intermediate filaments containing entrapped rough endoplasmic reticulum, mitochondria, and lipid. Recognition of this rare variant of malignant melanoma is important in the evaluation of tumors with rhabdoid morphology.

Prostate-specific membrane antigen (PSMA) fusion imaging in prostate cancer: PET/CT vs PET/MRI

2021 ◽  
Author(s):  
Feng-Yuan Liu ◽  
Ting-Wen Sheng ◽  
Jing-Ren Tseng ◽  
Kai-Jie Yu ◽  
Ke-Hong Tsui ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Local Recurrence ◽  
Cancer Patients ◽  
Primary Tumor ◽  
Tumor Staging ◽  
Distant Metastases ◽  
Local Tumor ◽  
Pet Ct ◽  
Primary Tumor Detection

Objectives: To investigate whether PET/CT or PET/MRI is more appropriate for imaging prostate cancer, in terms of for primary tumor detection, local staging and recurrence, as well as lymph nodes and distant metastases. Methods: A systematic literature search was conducted on Embase, PubMed/MEDLINE, and the Cochrane Library database. Studies evaluating the diagnostic performance of PET/CT vs PET/MRI in prostate cancer patients were emphasized. Results: We reviewed 57 original research articles during the period 2016—2021: 14 articles regarding the radiotracer PSMA; 18 articles regarding the primary tumor detection, local tumor staging, managing local recurrence; 17 articles for managing lymph node metastases; and eight articles for managing bone and other distant metastases. PSMA PET could be complementary to mpMRI for primary prostate cancer localization and is particularly valuable for PI-RADS three lesions. PET/MRI is better than PET/CT in local tumor staging due to its specific benefit in predicting extracapsular extension in MRI-occult prostate cancer patients. PET/MRI is likely superior as compared with PET/CT in detecting local recurrence, and have slightly higher detection rates than PET/CT in lymph node recurrence. PET/CT and PET/MRI seem to have equivalent performance in detecting distant bony or visceral metastases. Conclusion: In conclusion, PET/MRI is suitable for local and regional disease, either primary staging or restaging whereas PET/CT is valuable for managing distant bony or visceral metastasis. Advances in knowledge: We reviewed the emerging applications of PET/MRI and PET/CT in clinical aspects. Readers will gain an objective overview on the strength and shortfalls of PET/MRI or PET/CT in the management of prostate cancer.

scholarly journals Efficacy of povidone-iodine against accidental tumor incision during nephron-sparing surgery: experimental study in patients with renal cell carcinoma

2019 ◽  
Vol 47 (10) ◽  
pp. 4993-5002
Author(s):  
Gang Li ◽  
Chao Zhi ◽  
Dongsheng Zhu ◽  
Zihao Liu ◽  
Yuanjie Niu
Keyword(s):  
Renal Cell Carcinoma ◽  
Local Recurrence ◽  
Cell Carcinoma ◽  
Tumor Cells ◽  
Renal Cell ◽  
Povidone Iodine ◽  
Nephron Sparing Surgery ◽  
In Vitro Experiments ◽  
Nephron Sparing

Purpose Accidental tumor incision (ATI) can occur during nephron-sparing surgery (NSS) and correlates with recurrence and metastasis. This study investigated risk factors of intraoperative ATI in renal cell carcinoma (RCC) patients after NSS and the efficacy of povidone-iodine for ATI. Methods A retrospective analysis was performed on 150 consecutive stage I (pT1N0M0) RCC patients who underwent NSS at The Second Hospital of Tianjin Medical University between May 2010 and October 2015 for the causes of ATI. Furthermore, in vitro experiments investigated whether tumor cells remained on the surface of scissors and the effect of treatment with povidone-iodine on the number of remaining 786-O cells. Results Among the 150 cases, 15 showed ATI, of which three suffered local recurrence during a median follow-up of 56 months. Pseudocapsules, satellite nodules, and renal cystic tumors were observed in ATI cases. In vitro experiments showed that tumor cells remained on the surface of scissors after ATI during NSS and that 0.5% povidone-iodine effectively killed tumor cells in 30 minutes. Conclusions The probability of ATI is high in patients with complex-type RCC during NSS. ATI potentially increases the chance of metastasis and local recurrence, and 0.5% povidone-iodine kills tumor cells more effectively than distilled water.

Sign in / Sign up

Export Citation Format

Share Document