metastatic melanoma

转移性黑色素瘤
  • 文章类型: Case Reports
    原发性尿道黑素瘤是一种非常罕见的恶性肿瘤,包括一小部分影响女性尿道的黑色素瘤和恶性肿瘤。我们报告了一例74岁的女性,其症状最初提示良性尿道骨,后来在组织病理学检查中被诊断为结节性黑色素瘤。尽管完成了手术切除,随后的成像显示淋巴结广泛转移,肝脏,肺,和大脑。患者被及时转诊进行全身治疗。该病例突出了诊断挑战,并强调了彻底分期和新兴治疗方式的重要性。比如免疫疗法,在管理这种侵袭性恶性肿瘤方面。
    Primary urethral melanoma is an exceptionally rare malignancy, comprising a small fraction of melanomas and malignant tumors affecting the female urethra. We report the case of a 74-year-old woman presenting with symptoms initially suggestive of a benign urethral caruncle, which was later diagnosed as nodular melanoma upon histopathological examination. Despite complete surgical excision, subsequent imaging revealed widespread metastases to lymph nodes, liver, lungs, and brain. The patient was promptly referred for systemic therapy. This case highlights the diagnostic challenges and emphasizes the importance of thorough staging and emerging treatment modalities, such as immunotherapy, in managing this aggressive malignancy.
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  • 文章类型: Case Reports
    胸膜转移性黑色素瘤很罕见,和相关的恶性胸腔积液更为罕见。我们介绍了一例伴有复发性恶性胸腔积液的胸膜转移性黑色素瘤。初步诊断显示没有转移性疾病,患者接受了切除手术,并接受了一年的局部疾病免疫治疗.然而,两年后,患者出现胸膜转移性黑色素瘤伴无法解决的恶性胸腔积液,需要留置胸膜导管,最终,开胸手术。在复发性胸腔积液的情况下,临床医生应高度怀疑胸膜转移性黑色素瘤。尽管这是罕见的。
    Pleural metastatic melanoma is rare, and associated malignant pleural effusions are even rarer. We present a case of pleural metastatic melanoma with recurrent malignant pleural effusions. The initial diagnosis showed no metastatic disease, and the patient underwent resection and received a year of immunotherapy for localized disease. However, two years later, the patient presented with pleural metastatic melanoma with unresolving malignant pleural effusions requiring an indwelling pleural catheter and eventually, thoracotomy with decortication. Clinicians should have a high index of suspicion for pleural metastatic melanoma in the setting of recurrent pleural effusions, even though it is a rare occurrence.
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  • 文章类型: Journal Article
    小细胞黑色素瘤伪装成肾上腺非霍奇金淋巴瘤。该指数报告说明了转移到肾上腺的小细胞型恶性黑色素瘤的欺骗性细胞形态学特征。通过对细胞块切片进行免疫细胞化学来确认诊断。还强调了关键的细胞形态模拟物及其独特特征。
    Small-cell melanoma masquerading as an adrenal non-Hodgkin lymphoma. The index report illustrates the deceptive cytomorphologic features of a small cell type malignant melanoma metastatic to the adrenal gland. The diagnosis was confirmed by performing immunocytochemistry on the cell block sections. The key cytomorphologic mimics and their distinctive features have also been highlighted.
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  • 文章类型: Journal Article
    近年来,晚期和转移性黑色素瘤的治疗前景发生了巨大变化,随着免疫检查点抑制剂和靶向治疗等新型治疗方案的出现,与传统方法相比,该方法具有显着疗效并显着改善了患者预后。大约50%的黑色素瘤有激活的BRAF突变,超过90%导致BRAFV600E。用BRAF抑制剂单一疗法治疗的肿瘤在6个月内具有高的发展耐药率。与MEK抑制剂的联合治疗有助于减轻这种治疗耐药性并导致改善的结果。由于在BRAF/MEK抑制剂治疗的肿瘤中PD-1/PD-L1受体的上调,进一步的研究包括第三种联合药物,抗PD-1/PD-L1抑制剂。与单剂或双剂治疗方案相比,这种三联联合治疗可能具有更好的疗效和可控的安全性。
    晚期和转移性黑色素瘤的有效治疗可能具有挑战性。BRAF突变肿瘤患者的较新治疗方法包括具有不同互补机制的药物组合。这些药物包括BRAF抑制剂,MEK抑制剂,和PD-1/PD-L1抑制剂。当这三种药物联合使用时,患者可能有更好的反应率和生存结果,与一起使用这些药物中的一种或两种相比。三联用药方案的毒性更高,所以仔细选择病人是很重要的。
    The treatment landscape for advanced and metastatic melanoma has drastically changed in recent years, with the advent of novel therapeutic options such as immune checkpoint inhibitors and targeted therapies offering remarkable efficacy and significantly improved patient outcomes compared to traditional approaches. Approximately 50% of melanomas harbor activating BRAF mutations, with over 90% resulting in BRAF V600E. Tumors treated with BRAF inhibitor monotherapy have a high rate of developing resistance within six months. Combination therapy with MEK inhibitors helped to mitigate this treatment resistance and led to improved outcomes. Due to the up-regulation of PD-1/PD-L1 receptors in tumors treated with BRAF/MEK inhibitor therapy, further studies included a third combination agent, anti-PD-1/PD-L1 inhibitors. This triple combination therapy may have superior efficacy and a manageable safety profile when compared with single or double agent therapy regimens.
    Effective treatment of advanced and metastatic melanoma can be challenging. Newer treatment methods for patients with BRAF-mutated tumors include a combination of drugs with different complementary mechanisms. These drugs include BRAF-inhibitors, MEK-inhibitors, and PD-1/PD-L1 inhibitors. When these three medications are used in combination, patients may have better response rates and survival outcomes, when compared to using just one or two of these medications together. Toxicity rates are higher with a triple-medication regimen, so careful patient selection is important to consider.
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  • 文章类型: Journal Article
    TartroonD(TRL)是由Teredinibacterturnerae产生的,一种共生的降解纤维素的细菌。免疫原性细胞死亡(ICD)诱导有助于更好和更持久的抗癌治疗反应。接受ICD的肿瘤细胞会触发免疫系统的激活,作为疫苗。
    目的:本研究旨在评估TRL诱导ICD。
    方法:通过SRB测定评价细胞活力。细胞应激,细胞死亡,通过流式细胞术和免疫印迹评估ICD特征和抗原呈递分子。
    结果:TRL对7种肿瘤细胞系(L929,HCT116,B16-F10,WM293A,SK-MEL-28,PC-3M,和MCF-7)和非肿瘤细胞(HEK293A),抑制浓度平均值(IC50)为0.03uM至13uM。转移性黑色素瘤,SK-MEL-28,B16-F10,和WM293A,是更敏感的细胞系,IC50范围为0.07至1.2uM。TRL诱导细胞凋亡以及自噬和内质网应激,并释放ICD的典型损伤相关分子模式(DAMPs),如钙网蛋白,ERp57和HSP70暴露,和HMGB1释放。此外,暴露于TRL的黑色素瘤B16-F10增加了抗原呈递分子MHCII和CD1d的表达,并诱导了C57BL/6小鼠脾细胞的激活。
    结论:尽管靶向治疗和免疫疗法取得了最新进展,超过一半的患者无法治愈晚期转移性黑色素瘤.ICD诱导剂对抗癌治疗产生更好和持久的反应。我们的发现揭示了一种在黑色素瘤中诱导ICD的海洋抗癌候选物。
    Tartrolon D (TRL) is produced by Teredinibacter turnerae, a symbiotic cellulose-degrading bacteria in shipworm gills. Immunogenic cell death (ICD) induction contributes to a better and longer-lasting response to anticancer treatment. Tumor cells undergoing ICD trigger activation of the immune system, as a vaccine.
    OBJECTIVE: This study aimed to evaluate ICD induction by TRL.
    METHODS: Cell viability was evaluated by SRB assay. Cell stress, cell death, ICD features and antigen-presenting molecules were evaluated by flow cytometry and immunoblot.
    RESULTS: TRL showed antiproliferative activity on 7 tumor cell lines (L929, HCT 116, B16-F10, WM293A, SK-MEL-28, PC-3M, and MCF-7) and a non-tumor cell (HEK293A), with an inhibition concentration mean (IC50) ranging from 0.03 μM to 13 μM. Metastatic melanomas, SK-MEL-28, B16-F10, and WM293A, were more sensitive cell lines, with IC50 ranging from 0.07 to 1.2 μM. TRL induced apoptosis along with autophagy and endoplasmic reticulum stress and release of typical damage-associated molecular patterns (DAMPs) of ICD such calreticulin, ERp57, and HSP70 exposure, and HMGB1 release. Additionally, melanoma B16-F10 exposed to TRL increased expression of antigen-presenting molecules MHC II and CD1d and induced activation of splenocytes of C57BL/6 mice.
    CONCLUSIONS: In spite of recent advances provided by target therapy and immunotherapy, advanced metastatic melanoma is incurable for more than half of patients. ICD inducers yield better and long-lasting responses to anticancer treatment. Our findings shed light on an anticancer candidate of marine origin that induces ICD in melanoma.
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  • 文章类型: Published Erratum
    [这更正了文章DOI:10.3389/fimmu.2023.1180997。].
    [This corrects the article DOI: 10.3389/fimmu.2023.1180997.].
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  • 文章类型: Journal Article
    历史上,IV期黑色素瘤预后不佳,手术切除是唯一能长期生存或缓解有症状疾病的潜在治疗方法.现代系统疗法可以为许多转移性疾病患者提供持久的疾病控制,我们正在积极地重新定义手术在转移性黑色素瘤中的作用.当代的治疗策略可以在前期设置中采用手术切除,然后进行辅助治疗。或用于全身治疗后的定制方法。手术切除和现代疗法的结合与良好的长期生存率相关。
    Historically, stage IV melanoma carried a dismal prognosis and surgical resection was the only potential treatment offering long-term survival or palliation of symptomatic disease. With modern systemic therapies that can provide durable disease control for many patients with metastatic disease, we are actively redefining the role of surgery in metastatic melanoma. Contemporary treatment strategies can employ surgical resection in the upfront setting followed by adjuvant therapy, or used in tailored approach following systemic therapy. The combination of surgical resection and modern therapies has been associated with good long-term survival.
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  • 文章类型: Case Reports
    肠套叠是儿童肠梗阻的最常见原因之一;然而,成年人的发病率较低,在大多数情况下是由肿瘤引起的。胃肠道黑色素瘤相对罕见,仅报告了少量病例。大多数病例发生为皮肤原发病灶转移,小肠是胃肠道黑色素瘤转移最常见的部位。本研究描述了一个患有多发性软组织肿瘤的47岁男性患者的病例,最大的一个位于左臀区,尺寸14x15x20厘米。对该肿瘤进行了活检,并在透明细胞肉瘤和黑色素瘤之间进行了鉴别诊断。皮肤科医生对病人进行了评估,没有发现任何与皮肤黑素瘤相容的皮肤病变,并且由于回肠回肠肠套叠而被送往急诊室。病理分析的结果证实了黑色素瘤的最终诊断。总的来说,这些病变通常被诊断为症状的发作,预后不祥.
    Intestinal intussusception is one of the most common causes of intestinal obstruction in children; however, the incidence in adults is lower, and is caused by tumors in the majority of cases. Melanoma of the gastrointestinal tract is relatively rare, with only a small number of cases having been reported. The majority of cases occur as metastasis from cutaneous primary lesions, and the small bowel is the most common location of melanoma metastases in the gastrointestinal tract. The present study describes the case of a 47-year-old male patient with multiple soft tissue tumors, the largest one located in the left gluteal region, measuring 14x15x20 cm. This tumor was biopsied and a differential diagnosis was made between clear cell sarcoma and melanoma. The patient was evaluated by a dermatologist, without identifying any skin lesions compatible with cutaneous melanomas and was admitted to the emergency room due to an ileo-ileal intussusception. The results of the pathological analysis confirmed the final diagnosis of melanoma. On the whole, these lesions are usually diagnosed with the onset of symptoms, presenting an ominous prognosis.
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  • 文章类型: Case Reports
    心腔内受累的静脉血栓是一种罕见的疾病,与肾细胞癌有关。文献中很少有报道描述转移性黑色素瘤的这种表现。已知转移性黑色素瘤涉及肾上腺,尽管相关的肿瘤血栓延伸到肾静脉和下腔静脉是非常罕见的。在这个案例报告中,我们描述了转移性黑色素瘤的根治性肾切除术和肾上腺切除术。
    Caval thrombus with intracardiac involvement is a rare condition that is associated with renal cell carcinoma. Few reports in literature describe this presentation with metastatic melanoma. Metastatic melanoma is known to involve the adrenal gland, although associated tumor thrombus extension into the renal vein and inferior vena cava is extremely rare. In this case report, we describe radical nephrectomy and adrenalectomy for metastatic melanoma.
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  • 文章类型: Case Reports
    背景:黑色素瘤是一种侵袭性皮肤癌,以其显著的转移风险而闻名。膀胱转移很少见。
    方法:我们报告了一例75岁的女性,其黑色素瘤转移到膀胱,经尿道膀胱肿瘤电切术治疗,通过免疫组织化学证实。
    结论:膀胱镜检查对于所有有泌尿系症状的黑色素瘤患者都是必不可少的。治疗需要多学科方法。
    结论:尽管取得了进步,预后仍然受到保护,强调需要进一步研究以加强治疗策略。
    BACKGROUND: Melanoma is an aggressive form of skin cancer known for its significant risk of metastasis. Metastasis to the urinary bladder is rare.
    METHODS: We report a case of a 75-year-old woman with melanoma metastasis to the bladder treated with transurethral resection of the bladder tumor, confirmed by immunohistochemistry.
    CONCLUSIONS: Cystoscopy is essential for all melanoma patients presenting with urinary symptoms. Treatment necessitates a multidisciplinary approach.
    CONCLUSIONS: Despite advancements, the prognosis remains guarded, underscoring the need for further research to enhance therapeutic strategies.
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