penile melanoma

  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    粘膜黑素瘤(MM)是罕见的肿瘤,在所有被诊断的黑色素瘤中不到2%,由几乎所有粘膜上皮中的黑素细胞引起的各种恶性肿瘤组成,即使在口腔和鼻孔中更常见,肛门直肠和女性生殖器(外阴和阴道)。迄今为止,关于MM的最优管理策略尚无共识。此外,关于BRAF的分子肿瘤表征的临床原理,KIT或NRAS,以及免疫治疗的治疗价值,化疗和靶向治疗,尚未在MM中进行深入的探索和明确的建立。在本概述中,专注于肛门直肠和生殖器MM作为罕见黑色素瘤的模型,值得采用多学科方法,我们强调需要将这些患者转诊到黑色素瘤专家中心,肛门直肠和泌尿生殖道癌症治疗。考虑到稀有性,效果不佳,缺乏有效的MM治疗方案,需要及时促进量身定制的研究。
    Mucosal melanomas (MM) are rare tumors, being less than 2% of all diagnosed melanomas, comprising a variegated group of malignancies arising from melanocytes in virtually all mucosal epithelia, even if more frequently found in oral and sino-nasal cavities, ano-rectum and female genitalia (vulva and vagina). To date, there is no consensus about the optimal management strategy of MM. Furthermore, the clinical rationale of molecular tumor characterization regarding BRAF, KIT or NRAS, as well as the therapeutic value of immunotherapy, chemotherapy and targeted therapy, has not yet been deeply explored and clearly established in MM. In this overview, focused on anorectal and genital MM as models of rare melanomas deserving of a multidisciplinary approach, we highlight the need of referring these patients to centers with experts in melanoma, anorectal and uro-genital cancers treatments. Taking into account the rarity, the poor outcomes and the lack of effective treatment options for MM, tailored research needs to be promptly promoted.
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  • 文章类型: Journal Article
    BACKGROUND: Genital melanosis may clinically mimic melanoma. Little is known about the potential risk for genital and nongenital melanoma in these patients.
    OBJECTIVE: In this retrospective cohort study, we analyzed clinical and histologic data from patients with genital melanosis to better characterize these lesions and the risk they confer for genital and nongenital melanoma.
    METHODS: In all, 41 patients were identified for a retrospective chart review and histologic analysis.
    RESULTS: Genital melanosis can clinically mimic melanoma but the typical age of onset is younger than for genital melanoma. A majority of lesions were found to stabilize or regress over time. Five patients were found to have a history of melanoma, only 1 of which was in the genital region. Lesions from these patients were more likely to show melanocytes with suprabasal movement (P = .0101) and to have a higher melanocyte count (P < .0462).
    CONCLUSIONS: We present a relatively small cohort of patients with an average follow-up of only 30.5 months.
    CONCLUSIONS: Patients with genital melanosis, and in particular those with any level of histologic atypia in the genital melanosis lesion, may require careful total body skin examinations for the possibility of melanoma in any body site.
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  • 文章类型: Case Reports
    BACKGROUND: Endoscopic Inguinal Lymphadenectomy is an evolution of laparoscopic surgery thanks to background in these techniques. This is a new technique and the indications in the field of penile tumors today are expanding. The technique aims at reducing the morbidity of the procedure without compromising the cancer control or reducing the template of the dissection.
    METHODS: We present the modified endoscopic inguinal lymphadenectomy in a 70 years-old male patient with penile melanoma and positive sentinel lymph node in left inguinal limb. Intraoperative data, pathology, post operatory evolution and oncological follow-up is described
    RESULTS: Operative time was 120 min. Nine lymph nodes were retrieved and none of then showed positivity at pathology. There were no complications. The drain was kept for five days. After 12 months of follow up, no signs of disease progression were noted.
    CONCLUSIONS: The endoscopic inguinal lymphadenectomy is feasible in clinical practice. New studies with a greater number of patients and long-term follow-up may confirm the oncological efficacy and possible lower morbidity of these new approach.
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