Metastases from Melanoma of Unknown Origin

1969 ◽  
Vol 55 (6) ◽  
pp. 403-408
Author(s):  
Natale Cascinelli ◽  
Silvana Pilotti
Keyword(s):  
Malignant Melanoma ◽  
Lymph Nodes ◽  
Primary Melanoma ◽  
Unknown Origin ◽  
Primary Site

720 cases of malignant melanoma were treated in 30 years at the Cancer Institute of Milan. In 12 of these cases the primary site of the tumor remained unknown: metastases were found 10 times in the lymph nodes, twice in the subcutis, once in the bone (rib). The incidence of occult primary melanoma is 1.6 per cent.

scholarly journals Primary Solitary Melanoma of the Lymphatic Nodes Or a Single Metastasis of Unknown Melanoma: Do We Need a New Staging System?

2017 ◽  
Vol 5 (7) ◽  
pp. 970-973 ◽  
Author(s):  
Georgi Tchernev ◽  
Anastasiya Chokoeva ◽  
Lyubomira Victor Popova
Keyword(s):  
Lymph Node ◽  
Malignant Melanoma ◽  
Lymph Nodes ◽  
World Literature ◽  
Primary Tumour ◽  
Primary Melanoma ◽  
Staging System ◽  
Primary Site ◽  
Surgical Removal ◽  
Dermatology Clinic

BACKGROUND: Malignant melanoma is a disease which has a cutaneous origin in 90% of the patients, but in rare cases, it could be discovered as secondary deposits with unknown primary site. Metastatic Malignant Melanoma occurs without a primary site in about 3% of all melanoma patients, and it could be divided into two main groups: metastatic lymph nodes’ involvement or non-lymph nodes disease. The lack of unified classification and staging system, provided by AJCC (2009), as well as the lack for curtain diagnostic and therapeutic protocol, prompt us to raise the question what is the right way to precede in cases of metastasis of the lymph nodes, without evidence of a primary tumour?CASE REPORT: We report a case of 67-years- old woman who presented in the dermatology clinic after a surgical removal of an enlarged lymph node in her left femoral area, verified histologically as a metastasis of melanoma. After a diagnostic refinement in the clinic, the diagnosis of metastasis of malignant melanoma was confirmed by histology revision. We use the presented case to create for the first time in the world literature a novel stereotype of thinking, which is also followed by a stereotype of clinical behaviour – gentle to the patient, but providing a certain amount of security and satisfaction for the medical staff.CONCLUSION: The affection of a single lymph node in the absence of a primary tumour should not automatically lead to the conclusion that it is a single metastasis, but rather a primary melanoma of the lymph nodes, in cases of a negative PET scan, for example. In these cases, the measuring of the tumour thickness should guide the further therapeutic behaviour and determine the approach.

Malignant Melanoma of the Vulva

1970 ◽  
Vol 56 (6) ◽  
pp. 345-352 ◽  
Author(s):  
Natale Cascinelli ◽  
Francesco Di Re ◽  
Giovanni Lupi ◽  
Gian Paolo Balzarini
Keyword(s):  
Lymph Node ◽  
Malignant Melanoma ◽  
Lymph Nodes ◽  
Lymph Node Metastases ◽  
Primary Melanoma ◽  
Regional Lymph Nodes ◽  
Regional Metastases ◽  
Anatomical Extent ◽  
Node Metastases ◽  
Labium Majus

Many aspects of malignant melanoma of the vulva are still open questions and only appropriate clinical trials can supply the answers. However, we believe that the reporting of case-material can be of some use. Our series consists of 14 cases, that is 2% of all the melanomas observed. Most of the patients were past middle age, the average age being 59.7 years. The most frequent sites were the labium majus and the clitoris (5 cases per site); in 2 cases the urethral meatus was affected and in 2 cases the labium minus. There are virtually no subjective symptoms except for occasional reports of a burning sensation or pruritus. Terminal stranguria may be present in cases in which the urethral papilla is affected. The clinical diagnosis does not usually present serious difficulties. Cytomorphologic examination of the cells exfoliated by the tumor is highly reliable, sure in ulcerated cases. The histology of malignant melanoma of the vulva does not differ from that of other sites. Metastatisation to the regional lymph nodes is frequent; 8 of our cases already had lymph node metastases when first seen. Treatment depends on the anatomical extent of the disease. In cases without lymph node metastases the data of our series seem to indicate that radiotherapy can be at least a valid alternative to surgical removal. With regard to the treatment of clinically intact regional lymph nodes, a regional approach is ilioinguinal lymphadenectomy in the event of surgical attack on the primary melanoma, whereas if the primary melanoma is to be treated by radiotherapy lymphadenectomy should be performed only if lymph node metastases appear. As to whether lymphadenectomy should be uni- or bilateral, our data indicate that the cases in which the melanoma lies on the midline (urethral meatus and clitoris) have a high incidence of bilateral metastases and so in these cases lymphadenectomy should be bilateral. On the other hand, when the labium majus is affected, unilateral lymph node dissection is sufficient. In cases with clinically detectable regional metastases enlarged vulvectomy is always indicated. Cases with distant metastases should receive chemotherapy. The drug that has so far yielded the greatest number of regressions is 5-imidazolcarboxamide. The prognosis depends on the anatomical extent of the disease. In this series 2 of the 4 cases without metastases to the regional lymph nodes are living 5 years after surgery whereas none of the 7 patients with regional metastases is alive after 5 years.

scholarly journals Malignant Melanoma of Cervical and Parotid Lymph Nodes With an Unknown Primary Site

1994 ◽  
Vol 104 (10) ◽  
pp. 1194???1198 ◽  
Author(s):  
Sina Nasri ◽  
Ali Namazie ◽  
Pavel Dulguerov ◽  
Robert Mickel
Keyword(s):  
Malignant Melanoma ◽  
Lymph Nodes ◽  
Primary Site ◽  
Unknown Primary ◽  
Unknown Primary Site

Cystic metastatic lymph nodes in malignant melanoma: a case report

2017 ◽  
Vol 42 ◽  
pp. 158-160
Author(s):  
Eralda Mema ◽  
Emma Cho ◽  
Richard Ha ◽  
Bret Taback
Keyword(s):  
Case Report ◽  
Malignant Melanoma ◽  
Lymph Nodes ◽  
Metastatic Lymph Nodes ◽  
Metastatic Lymph

scholarly journals BRAF/NRAS Mutation Frequencies Among Primary Tumors and Metastases in Patients With Melanoma

2012 ◽  
Vol 30 (20) ◽  
pp. 2522-2529 ◽  
Author(s):  
Maria Colombino ◽  
Mariaelena Capone ◽  
Amelia Lissia ◽  
Antonio Cossu ◽  
Corrado Rubino ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Primary Melanoma ◽  
Similar Distribution ◽  
Nras Mutation ◽  
Tissue Samples ◽  
Primary Tumors ◽  
Paired Samples ◽  
Automated Dna Sequencing ◽  
Tumor Tissues ◽  
Visceral Metastases

Purpose The prevalence of BRAF, NRAS, and p16CDKN2A mutations during melanoma progression remains inconclusive. We investigated the prevalence and distribution of mutations in these genes in different melanoma tissues. Patients and Methods In all, 291 tumor tissues from 132 patients with melanoma were screened. Paired samples of primary melanomas (n = 102) and synchronous or asynchronous metastases from the same patients (n = 165) were included. Tissue samples underwent mutation analysis (automated DNA sequencing). Secondary lesions included lymph nodes (n = 84), and skin (n = 36), visceral (n = 25), and brain (n = 44) sites. Results BRAF/NRAS mutations were identified in 58% of primary melanomas (43% BRAF; 15% NRAS); 62% in lymph nodes, 61% subcutaneous, 56% visceral, and 70% in brain sites. Mutations were observed in 63% of metastases (48% BRAF; 15% NRAS), a nonsignificant increase in mutation frequency after progression from primary melanoma. Of the paired samples, lymph nodes (93% consistency) and visceral metastases (96% consistency) presented a highly similar distribution of BRAF/NRAS mutations versus primary melanomas, with a significantly less consistent pattern in brain (80%) and skin metastases (75%). This suggests that independent subclones are generated in some patients. p16CDKN2A mutations were identified in 7% and 14% of primary melanomas and metastases, with a low consistency (31%) between secondary and primary tumor samples. Conclusion In the era of targeted therapies, assessment of the spectrum and distribution of alterations in molecular targets among patients with melanoma is needed. Our findings about the prevalence of BRAF/NRAS/p16CDKN2A mutations in paired tumor lesions from patients with melanoma may be useful in the management of this disease.

Heterogeneous Patterns of Lymphatic Drainage to Sentinel Lymph Nodes by Primary Melanoma From Different Anatomic Sites

2005 ◽  
Vol 30 (3) ◽  
pp. 150-158 ◽  
Author(s):  
Stanley P. L. Leong ◽  
Eugene T. Morita ◽  
Martin S??dmeyer ◽  
Jeffrey Chang ◽  
David Shen ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Primary Melanoma ◽  
Lymphatic Drainage ◽  
Sentinel Lymph Nodes

scholarly journals Failure patterns of cervical lymph nodes in metastases of unknown origin according to target volume

2020 ◽  
Vol 38 (1) ◽  
pp. 18-25
Author(s):  
Dong-Yun Kim ◽  
Dae Seog Heo ◽  
Bhumsuk Keam ◽  
Chan Young Ock ◽  
Soon Hyun Ahn ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Unknown Origin ◽  
Target Volume ◽  
Cervical Lymph Nodes ◽  
Failure Patterns

Melanoma without a Detectable Primary Site with Metastases to Lymph Nodes

2010 ◽  
Vol 36 (6) ◽  
pp. 868-876 ◽  
Author(s):  
PIOTR RUTKOWSKI ◽  
ZBIGNIEW I. NOWECKI ◽  
WIRGINIUSZ DZIEWIRSKI ◽  
MARCIN ZDZIENICKI ◽  
ANDRZEJ PIEÑKOWSKI ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Primary Site
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