1/43. Desmoplastic spindle-cell melanoma of the eyelid with orbital invasion.PURPOSE: To describe the clinicopathologic features of a patient with a spindle-cell melanoma of the eyelid that exhibited orbital invasion. methods: Case report. RESULTS: A slowly enlarging mass developed in the eyelid of a 50-year-old woman. Excision of the mass showed desmoplastic spindle-cell melanoma. The tumor recurred in the orbit, and an exenteration was performed. A second recurrence 7 months later was treated with radiation therapy. CONCLUSIONS: There is a continuum of spindle-cell to desmoplastic melanoma. The prognosis of patients with orbital invasion of melanoma is poor, and adjuvant treatment including radiation and chemotherapy has little benefit.- - - - - - - - - - ranking = 1keywords = melanoma (Clic here for more details about this article) |
2/43. Treatment of malignant melanoma of the lower eyelid using anterolateral thigh flap.Malignant melanoma is a poor prognostic disease with the potential for high mortality despite early diagnosis and currently available treatment. Surgical judgment pertaining to the extent of primary resection and regional node dissections must be tempered by cosmetic considerations and by the anatomically diffuse pathways for lymphatic spread in certain lesions. We reported a case of malignant melanoma of the left lower eyelid, and presented the surgical excision and reconstruction using anterolateral thigh flap for skin defect. It is evident that comprehensive treatment using radical surgery and adjuvant chemotherapy is necessary for cutaneous malignant melanoma of head and neck areas.- - - - - - - - - - ranking = 1.4583995155862keywords = melanoma, malignant melanoma (Clic here for more details about this article) |
3/43. Sentinel node biopsy for orbital and ocular adnexal tumors.PURPOSE: To describe a technique for sentinel node mapping and biopsy in patients with orbital or adnexal tumors. methods: Five patients with orbital and adnexal tumors were studied. Two patients had malignant eyelid melanomas (one of the skin and one of the conjunctiva), one with orbital invasion. Two patients had sebaceous gland carcinoma, and one patient had a mucoepidermoid carcinoma of the conjunctiva; 500 microCi of technetium-99m sulfur nanocolloid (Nycomed Amersham, Princeton, NJ) diluted to 1.0 mL was injected intradermally at the lateral canthus. The patients were positioned as they would be during surgery. lymphoscintigraphy was performed by means of anterior, lateral, and oblique views. The tracer was followed to the first lymphatic basin, and the sentinel node was identified. Cutaneous markers were placed to denote the site. During surgery, lymphoscintigraphy scans and a hand-held gamma probe were used to locate the sentinel node. Once excised, the sentinel node was sent for histopathology. Frozen sectioning confirmed the presence of lymphoid tissue. Permanent sections with immunohistochemical markers were performed to examine for metastatic disease. RESULTS: The sentinel node biopsy technique was applied to 5 patients with orbital and adnexal tumors. All lymph nodes were free of tumor on histopathologic examination. CONCLUSIONS: Sentinel node mapping and biopsy are possible for orbital and adnexal tumors. The morbidity of elective lymph node dissection and adjuvant radiotherapy can be avoided. Our results are preliminary, and further work must be done to identify the lymphatic basins of the orbit and ocular adnexa.- - - - - - - - - - ranking = 0.125keywords = melanoma (Clic here for more details about this article) |
4/43. Multiple neoplasms: a case report.patients diagnosed with Chronic Lymphocytic leukemia (CLL) have an increased risk of developing second primary cancers. However, as far as we know, more than one type of subsequent malignancy in one patient has not been described. We report a case of two different skin cancers following CLL. A 68-year-old female patient, in whom CLL was diagnosed 5 years earlier, presented with a pigmentation in the left lower eyelid. biopsy showed a melanoma. The tumor was excised and histopathological examination revealed a superficial spreading melanoma. Half a year later, a new pigmented tumor was seen in the transplant of the left lower eyelid. biopsy was performed and histopathological examination showed an intraepithelial squamous cell carcinoma. This was treated with 5 fluorouracil 1% eyedrops.- - - - - - - - - - ranking = 0.25keywords = melanoma (Clic here for more details about this article) |
5/43. Lid melanoma and parkinsonism.This is a case report of a patient with parkinsonism on levodopa therapy who developed a lid margin melanoma. The possible association is discussed.- - - - - - - - - - ranking = 0.625keywords = melanoma (Clic here for more details about this article) |
6/43. High-frequency ultrasound imaging of periocular hidrocystomas.BACKGROUND: High-frequency ultrasound has improved our ability to manage and diagnose anterior segment tumors. Hidrocystomas are unusual cystic tumors that can affect the conjunctiva and eyelid. When they appear pigmented and rapid in onset, it is important to differentiate them from malignant tumors, such as melanoma. case reports: Three patients were referred to The new york eye Cancer Center for evaluation of pigmented lesions on their eyes. The tumors affected the conjunctiva or eyelid and were of recent onset ranging from 1 week to 6 months. The hidrocystomas displayed hypoechoic high-frequency ultrasound patterns, which corresponded to the cystic nature revealed through histopathological analysis. Differential diagnoses are discussed and include benign and malignant tumors. CONCLUSION: Cystic tumors are a common finding of the eye; however, pigmented hidrocystoma is an uncommon diagnosis. Although histopathological study is often required for definitive diagnosis of these lesions, much information can be gained through pre-surgical evaluation, particularly high-frequency ultrasound. Intra-lesional cyst formation was characteristic in these three tumors. Further study of the high-frequency ultrasound characteristics of pigmented eyelid and conjunctival tumors will help determine if these ultrasound characteristics are diagnostic.- - - - - - - - - - ranking = 0.125keywords = melanoma (Clic here for more details about this article) |
7/43. Immunohistochemical diagnosis of a rare case of epithelioid malignant peripheral nerve sheath tumor with multiple metastases.BACKGROUND: The epithelioid variant of malignant peripheral nerve sheath tumor (MPNST) is a rare tumor with poor prognosis that sometimes involves the head and neck. The diagnosis is based principally on the histological examination, and it is generally very difficult to reach the correct diagnosis. CASE: An 84-year-old Japanese woman presented with a tumor mass of 2 week's duration in the right medial canthal region. OBSERVATIONS: Although the tumor was excised surgically, metastases occurred three times on her face and head, and the patient died of distant systemic multiple metastases. In the histopathological analysis, the tumor showed a composite pattern comprising spindle or polygonal cells arranged in irregular bands, and a population of larger epithelioid cells in solid sheets and nests. In the immunohistochemical analysis, the tumor cells were positive for S-100 protein, vimentin, and nerve growth factor receptor (NGFR), and negative for cytokeratin and HMB 45 (melanoma-associated antigen). These findings confirmed the diagnosis of MPNST. CONCLUSIONS: Epithelioid MPNST has complex histopathological findings and histopathological features similar to other epithelioid tumors, especially malignant melanoma. Immunohistochemical examination using NGFR and HMB-45 is important in the differential diagnosis.- - - - - - - - - - ranking = 0.3472332525977keywords = melanoma, malignant melanoma (Clic here for more details about this article) |
8/43. Hughes technique, amniotic membrane allograft, and topical chemotherapy in conjunctival melanoma with eyelid involvement.A 59-year-old woman presented with a pigmented mass in the inferior tarsal conjunctiva of the left eye with an associated diffuse, multifocal pigmentation involving largely the inferior half of the bulbar conjunctiva, fornix, and eyelid skin. Histopathologic examination of map biopsies disclosed conjunctival melanoma from primary acquired melanosis. Surgical excision of the inferior bulbar conjunctiva, fornix, and lower eyelid with histopathologic free margins was performed. Adjuvant cryotherapy was applied. The bulbar conjunctiva and lower fornix were reconstructed with an amniotic membrane allograft. Lower eyelid reconstruction was accomplished by use of the Hughes technique. Topical mitomycin C (0.04%) was applied after surgery. After 2 years of follow-up, no tumor recurrence has been detected and the eyelid and conjunctival defect have been satisfactorily corrected. This combined surgical procedure using amniotic membrane allograft and a composite tarsoconjunctival flap is shown to be useful in the treatment of an advanced conjunctival neoplasia with extensive eyelid involvement.- - - - - - - - - - ranking = 0.625keywords = melanoma (Clic here for more details about this article) |
9/43. Unspecific redness of the eyelid--two malignant tumours.BACKGROUND: Chronic, non- or little pigmented reddish or brownish lesions on the lid margin and the surrounding skin are frequently underestimated and thus carry a clear risk of malignancy. history AND SIGNS: A 61-year-old lady was referred with a chronic, reddish lesion in the medial third of the left lower lid after a topical therapy over a period of 4 months had not improved the situation. She noticed the lesion for the first time 10 previously. Recurrent trichiasis and a slight ulceration had developed during the last year. THERAPY AND OUTCOME: After an unclear result of the biopsy (2)/ (3) of the left lower lid were removed because of atypical cells ascending into the epidermis. A superficial spreading melanoma 0.4 mm depth in the Breslow classification was detected and right next to it a superficial basal cell carcinoma. The lid defect was reconstructed with a tarsoconjunctival flap and a free full thickness skin graft as described by Hughes. CONCLUSION: Chronic redness at or around the lid margin which does not respond to therapy should be biopsied as malignant tumours may well be hidden behind it.- - - - - - - - - - ranking = 0.125keywords = melanoma (Clic here for more details about this article) |
10/43. Amelanotic malignant melanoma of the conjunctiva with local metastasis to the eyelid.Conjunctival melanomas are uncommon. The amelanotic variety is extremely rare. We describe a patient with an amelanotic melanoma of the superior conjunctiva that was primarily excised, followed by extensive conjunctival resection and liquid nitrogen cryotherapy applied to the tumour bed. Eight months later a local metastatic lesion was noted in the lower eyelid. Eyelid metastasis in conjunctival melanoma is uncommon but may occur owing to the rich lymphatic vasculature within the conjunctiva.- - - - - - - - - - ranking = 1.2639330103908keywords = melanoma, malignant melanoma (Clic here for more details about this article) |
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