1/12. Laparoscopic postmortem examination: a minimally invasive approach to the autopsy.Laparoscopic and thoracoscopic autopsies have previously only been performed on an experimental basis to determine their potential usefulness as a substitute for a conventional postmortem examination. We present the case of a patient with an unusual variant of malignant melanoma (diffuse melanosis) in whom the immediate cause of death clinically was thought to be fulminant hepatic failure, the etiology of which was unknown. The family was unwilling to consent to a conventional autopsy, but would permit a postmortem examination limited to a 2-cm abdominal incision and removal of a sample of liver. In view of the unanswered clinical questions regarding the cause of the acute hepatic failure and its possible relationship to the diagnosis of diffuse melanosis, we decided that more extensive examination of the abdominal cavity, specifically the liver, was required and that the only way that this could be accomplished was by laparoscopic techniques. Laparoscopic examination of the abdominal cavity revealed multiple melanotic nodules on the surface of the liver and studding the omentum. Multiple liver samples were easily obtained; these revealed massive diffuse necrosis of the liver parenchyma with scattered nodular deposits of dark pigment consistent with melanin. We report the first known case in which a laparoscopic autopsy was used to obtain valuable information that answered clinically relevant questions. Laparoscopic autopsy can offer the a family that is unwilling to consent to a conventional postmortem examination an alternative that can potentially provide answers to clinical questions that otherwise would have been unresolved.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
2/12. Peritoneal "melanosis" associated with a ruptured ovarian dermoid cyst: report of a case with electron-probe energy dispersive X-ray analysis.A case of peritoneal "melanosis" due to a ruptured left ovarian dermoid cyst is described. histology showed that the dermoid contained gastric mucosa associated with ulceration, necrosis, and hemorrhage. The areas of pigmentation within the dermoid, omentum, and peritoneal cavity were due to collections of heavily pigment-laden macrophages. The pigment lacked the histochemical features of either melanin or hemosiderin, but electron-probe energy dispersive x-ray analysis showed that the pigment contained a high concentration of iron. It is postulated that peptic ulceration with hemorrhage is the most likely source of the pigment and that the peritoneal pigmentation is secondary to spillage of the contents of the dermoid cyst.- - - - - - - - - - ranking = 0.5keywords = cavity (Clic here for more details about this article) |
3/12. Oral melanotic macule--a case report.A melanotic macule is a benign pigmented lesion of oral cavity characterised by increase in melanin pigmentation. Presented here is a case report of 12 year old girl with black pigmented area on right buccal mucosa. An excision biopsy was done which confirmed the diagnosis by as melanotic macule.- - - - - - - - - - ranking = 15.771452340368keywords = oral cavity, cavity (Clic here for more details about this article) |
4/12. Pigmented mucoepidermoid carcinoma of the oral cavity: a case report.melanocytes are normally present in the oral mucosa, but unlike the skin, melanocytic colonization and pigmentation of nonmelanocytic tumors rarely occur. A case of pigmented mucoepidermoid carcinoma (MEC) in a 36-year-old woman is reported. On H&E-stained sections, brownish granules were seen in intermediate and epidermoid neoplastic elements and in elongated or dendritic cells showing histologic and immunohistochemical features of melanocytes. Ultrastructurally numerous epithelial cells contained large aggregates of melanin granules, a feature suggestive of phagocytosis. In addition small individual melanin granules were observed at the external border of the epithelial cell membrane. These features suggest that melanocytes colonized the MEC and that neoplastic cells may phagocytose the granules, similarly to what occurs with epidermal melanocytes. The phenomenon of melanocyte colonization of nonmelanocytic tumors should be taken into consideration in dealing with pigmented lesions of the oral cavity.- - - - - - - - - - ranking = 78.857261701842keywords = oral cavity, cavity (Clic here for more details about this article) |
5/12. Oral pigmentation induced by Premarin.Pigmented lesions of the oral cavity are important entities. The wide range of their clinical differential diagnosis includes such diverse systemic conditions as Addison's disease, peutz-jeghers syndrome, malignant melanoma, Kaposi's sarcoma, as well as specific oral lesions, such as amalgam tattoo or gingival melanosis. This paper reports a very rare cause of oral pigmentation, a melanic type, related to the use of Premarin.- - - - - - - - - - ranking = 15.771452340368keywords = oral cavity, cavity (Clic here for more details about this article) |
6/12. Pigmented lesions of the oral cavity.The factors that produce dark pigmentation of the oral soft tissues are described. Examples are given of aberrations of the melanin-forming cells in the oral cavity and a new case of oral blue nevus is added to the literature. A unique case of localized melanosis of the tongue is described clinically and histopathologically.- - - - - - - - - - ranking = 78.857261701842keywords = oral cavity, cavity (Clic here for more details about this article) |
7/12. melanosis, melanocytic hyperlasia, and primary malignant melanoma of the nasal cavity.A primary multifocal intranasal malifnant melanoma is reported in a 54-year-old black female. Diffuse pigmentation (melanosis) of nasal and maxillary sinus mucosa corresponds histologically to hyperplasia of dendritic melanocytes, from which cells the tumor is considered to originate.- - - - - - - - - - ranking = 2keywords = cavity (Clic here for more details about this article) |
8/12. melanoma and the differential diagnosis of oral pigmented lesions.There are many pathologic processes that occur in the mouth which have various intraoral manifestations. The differential diagnosis of pigmented lesions of the oral cavity takes on a high degree of significance because therapy may span such a wide range from no treatment at all to massive radical resection for melanoma. A thorough understanding of pigmented lesions of the oral cavity would assist the clinician in establishing a diagnosis and subsequent treatment plan. A comprehensive review of the literature and a discussion of oral pigmented lesions including infiltrative malignant melanoma is presented.- - - - - - - - - - ranking = 31.542904680737keywords = oral cavity, cavity (Clic here for more details about this article) |
9/12. Mucosal melanomas of the head and neck.Mucosal melanoma of the head and neck is a rare condition. This study presents a review of 26 patients with such tumors, followed up at a minimum of 5 years. The 5-year survival rate in this group was 38%. Recurrences with a fatal outcome, however, have been encountered up to 12 years after initial diagnosis. Primary radical surgery offers the best chance for local control. Nasal-cavity lesions seem to be associated with a better prognosis than oral-cavity tumors. Analysis of pathologic features by microstage measurement showed that the majority of tumors were of considerable thickness. This factor may partially explain the poor prognosis associated with mucosal melanomas in comparison to their cutaneous counterparts. Local recurrences and distant metastases were the principal causes of treatment failure. A persistent treatment policy, however, may still substantially prolong survival in such cases. Regional lymph-node metastasis did not pose a significant problem in the management of these tumors. Recognition of the nature and significance of the appearance of oral melanosis is stressed.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
10/12. Generalized melanosis with malignant melanoma metastasizing to skin--a pathological study with S-100 protein and HMB-45.A patient with primary malignant melanoma localized to the right gluteal region is described. Four years later and after intercurrent influenza, disseminated metastases of malignant melanoma to the skin occurred. After a further 6 months melanodermia developed and lasted until the death of the patient (6 months later). autopsy revealed melanosis of the visceral organs. histology taken from internal organs using S-100 protein and HMB-45 melanoma methods confirmed metastases of malignant melanoma to the skin, oral cavity, palatal tonsils, nasal and nasopharyngeal mucosae, lungs, myocardium and brain. The authors discuss the mechanism of melanosis--a rare sign in patients with metastasizing malignant melanoma.- - - - - - - - - - ranking = 15.771452340368keywords = oral cavity, cavity (Clic here for more details about this article) |
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