scholarly journals Dermoscopic Predictors of Tumor Thickness in Cutaneous Melanoma: A Retrospective Analysis of 245 Melanomas

2021 ◽  
pp. 2021059
Author(s):  
Enrique Rodríguez-Lomba ◽  
Belén Lozano-Masdemont ◽  
Lula María Nieto-Benito ◽  
Elisa Hernández de la Torre ◽  
Ricardo Suárez-Fernández ◽  
...  
Keyword(s):  
Case Series ◽  
Tumor Thickness ◽  
Retrospective Evaluation ◽  
Single Institution ◽  
Melanoma In Situ ◽  
Subjective Evaluations ◽  
Node Biopsy ◽  
Current Guidelines ◽  
Black Pigmentation

Introduction: The literature regarding the association of dermoscopic structures with Breslow thickness in melanoma is scarce, limited to small case series, and mostly outdated. Objective: This study determined the dermoscopic patterns, colors and structures that are associatedwith melanoma in situ, thin melanomas (<0.8 mm) and thick melanomas potentially requiring sentinellymph node biopsy according to current guidelines (≥0.8 mm). Methods: A retrospective evaluation of 245 dermoscopic images of primary cutaneous melanomalocated on the trunk or limbs was performed by consensus of 2 dermoscopists. Results: Red-pink, blue-gray and white color, blue-white veil, shiny white streaks, irregular vessels,blue-black pigmentation, milky red areas, pseudolacunae, ulceration and rainbow pattern were associated with thickness ≥0.8 mm, whereas atypical pigmented network, regression and hypopigmentedareas were significantly associated with early melanomas. Limitations: This is a retrospective study performed in a single institution. Melanomas of specialsites were excluded from our evaluation. Dermoscopy is based on subjective evaluations that dependlargely on the observers’ experience. Conclusions: The identification of certain dermoscopic structures and colors might help in the discrimination between thin and thick melanomas.

scholarly journals Dermoscopic features of thin melanomas: a comparative study of melanoma in situ and invasive melanomas smaller than or equal to 1mm

2013 ◽  
Vol 88 (5) ◽  
pp. 712-717 ◽  
Author(s):  
Vanessa Priscilla Martins da Silva ◽  
Juliana Kida Ikino ◽  
Mariana Mazzochi Sens ◽  
Daniel Holthausen Nunes ◽  
Gabriella Di Giunta
Keyword(s):  
Lymph Node ◽  
Retrospective Study ◽  
Sentinel Lymph Node ◽  
Statistical Significance ◽  
Lymph Node Biopsy ◽  
Melanoma In Situ ◽  
Node Biopsy ◽  
Breslow Index

BACKGROUND: Dermoscopy allows the early detection of melanomas. The preoperative determination of Breslow index by dermoscopy could be useful in planning the surgical approach and in selecting patients for sentinel lymph node biopsy. OBJECTIVES: This study aims at describing the dermoscopic features of thin melanomas and comparing melanomas in situ with invasive melanomas less than or equal to 1 mm thick. METHODS: This was an observational retrospective study in which the dermoscopy photographs of 41 thin melanomas were evaluated. Three observers evaluated together 14 dermoscopic criteria. RESULTS: Among thin melanomas, the most frequent criteria were presence of asymmetry in two axes in 95% of cases (39 cases), 3 or more colors in 80.4% of cases (33 cases), atypical dots or globules in 58.5% of cases (24 cases) and atypical network or streaks in 53.6% of cases (22 cases). The group of invasive melanomas presented with a higher frequency and statistical significance (p <0.05) 3 or more colors (OR: 16.1), milky red areas (OR: 4.8) and blue-white veil (OR: 20.4), and a greater tendency to have streaks or atypical network (OR: 3.66). CONCLUSIONS: Thin melanomas tend to have asymmetry in the two axes, 3 or more colors, atypical dots or globules and atypical network or streaks. Melanomas in situ tend to have up to 2 colors, no blue-white veil and no milky red area. Invasive melanomas tend to have 3 or more colors, a milky red area, blue-white veil, and atypical network or streaks. Further studies are needed to confirm these findings.

Current guidelines on the diagnosis and management of lobular carcinoma in situ

2017 ◽  
Vol 15 (1) ◽  
pp. 87-90
Author(s):  
Ewa Śrutek ◽  
◽  
Tomasz Nowikiewicz ◽  
Wojciech Zegarski ◽  
◽  
...  
Keyword(s):  
Carcinoma In Situ ◽  
Lobular Carcinoma ◽  
Lobular Carcinoma In Situ ◽  
Diagnosis And Management ◽  
Current Guidelines

Long-term outcomes of lumbar microdiscectomy in the pediatric population: a large single-institution case series

2019 ◽  
Vol 24 (5) ◽  
pp. 549-557
Author(s):  
Malia McAvoy ◽  
Heather J. McCrea ◽  
Vamsidhar Chavakula ◽  
Hoon Choi ◽  
Wenya Linda Bi ◽  
...  
Keyword(s):  
Conservative Management ◽  
Functional Outcomes ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Case Series ◽  
Csf Leak ◽  
Single Institution ◽  
The Mean

OBJECTIVEFew studies describe long-term functional outcomes of pediatric patients who have undergone lumbar microdiscectomy (LMD) because of the rarity of pediatric disc herniation and the short follow-up periods. The authors analyzed risk factors, clinical presentation, complications, and functional outcomes of a single-institution series of LMD patients over a 19-year period.METHODSA retrospective case series was conducted of pediatric LMD patients at a large pediatric academic hospital from 1998 to 2017. The authors examined premorbid risk factors, clinical presentation, physical examination findings, type and duration of conservative management, indications for surgical intervention, complications, and postoperative outcomes.RESULTSOver the 19-year study period, 199 patients underwent LMD at the authors’ institution. The mean age at presentation was 16.0 years (range 12–18 years), and 55.8% were female. Of these patients, 70.9% participated in competitive sports, and among those who did not play sports, 65.0% had a body mass index greater than 25 kg/m2. Prior to surgery, conservative management had failed in 98.0% of the patients. Only 3 patients (1.5%) presented with cauda equina syndrome requiring emergent microdiscectomy. Complications included 4 cases of postoperative CSF leak (2.0%), 1 case of a noted intraoperative CSF leak, and 3 cases of wound infection (1.5%). At the first postoperative follow-up appointment, minimal or no pain was reported by 93.3% of patients. The mean time to return to sports was 9.8 weeks. During a mean follow-up duration of 8.2 years, 72.9% of patients did not present again after routine postoperative appointments. The total risk of reoperation was a rate of 7.5% (3.5% of patients underwent reoperation for the same level; 4.5% underwent adjacent-level decompression, and one patient [0.5%] ultimately underwent a fusion).CONCLUSIONSMicrodiscectomy is a safe and effective treatment for long-term relief of pain and return to daily activities among pediatric patients with symptomatic lumbar disc disease in whom conservative management has failed.

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