Cases reported "Melanoma"

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1/148. Primitive sinonasal malignant mucosal melanoma: description of a case treated with radiotherapy (0-7-21 regimen).

    Mucosal malignant melanoma (MMM) of the nasal cavity and paranasal sinuses is rare and has a poor prognosis. The rarity of MMM of the ethmoid is also noteworthy and primary treatment has been, till now, surgery and/or radiotherapy (RT). Here we report a case of MMM arising in the ethmoid of a caucasian man and treated with hypofractionated RT. A 32 year-old man presented with symptoms of cephalalgia, obstruction and nasal bleeding; a computed tomography (CT) showed a large mass that involved ethmoid, left orbit and roof of the nasal cavity. After biopsy, a MMM was found. Chest radiography demonstrated the presence of multiple lung metastases and still the patient was submitted to palliative radiotherapy according to 0-7-21 regimen with a total dose of 24Gy/3 fraction/21dd, dose per fraction 8Gy. The patient was asymptomatic one month after the end of RT and three months later a CT demonstrated a partial remission. The patient died 17 months after the initiation of RT for disseminated disease, without clinical signs of tumoral regrowth in the irradiated site. This case confirms the efficacy and the safety of 0-7-21 RT regimen; the absence of symptoms after 17 months and the poor prognosis encourage the use of RT as primary treatment for MMM of the head and neck.
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2/148. FDG PET-negative liver metastases of a malignant melanoma and FDG PET-positive hurthle cell tumor of the thyroid.

    A Hurthle cell tumor (oncocytoma) of the thyroid presented as a hypermetabolic focus in a fluorodeoxyglucose positron emission tomography (FDG PET) study which was performed as staging procedure in a patient with malignant melanoma. This finding led to the initial diagnosis of a metastasis. In contrast, multiple liver metastases, seen on MRI and sonography, did not show any increased FDG uptake. Cytology results of one liver mass confirmed a melanoma metastasis, and of the neck mass, a Hurthle cell tumor. The Hurthle cell tumor was, based on clinical evidence, thought to be benign. This is the first description of a FDG PET-positive benign Hurthle cell tumor, with FDG PET-negative liver metastases of a malignant melanoma, in the same patient.
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3/148. Bilateral tinea nigra plantaris and tinea nigra plantaris mimicking melanoma.

    tinea nigra, a superficial fungal infection caused by Phaeoannellomyces werneckii, presents as a hyperpigmented, nonscaling macule of variable size and shape. Typically lacking induration, erythema, or pruritus, these "ink spot" lesions may resemble junctional nevi or malignant melanoma. Rapid, noninvasive diagnosis can be provided by potassium hydroxide examination, demonstrating numerous large, dematiaceous hyphae.
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4/148. De-epithelialised anterior (anterolateral and anteromedial) thigh flaps for dead space filling and contour correction in head and neck reconstruction.

    Anterior (anterolateral and anteromedial) thigh flaps based on the descending branch of the lateral circumflex femoral vessels provide a long vascular pedicle and a large flap without sacrificing main vessels and muscles. Twenty-eight de-epithelialized anterior thigh flaps were transferred for reconstruction of head and neck defects following tumour ablation. Two flaps were lost in patients that had previously undergone high-dose radiotherapy following free tissue transfer. Vascularised fibula, vascularised iliac bone and other tissues were combined with anterior thigh flaps in 13 cases utilising the distal end or derivative branches of the vascular pedicle. Salivary fistula was seen in only one case, although there were many minor and major complications. In five cases, double skin flaps were harvested from the ipsilateral thigh. One of these flaps was used for coverage of intraoral defects, while the other was placed in the submandibular area to fill dead space. Compared with other methods, this multi-flap method is considered to be most suitable for dead space filling and contour correction.
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5/148. 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.
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6/148. polymyositis occurring during alpha-interferon treatment for malignant melanoma: a case report and review of the literature.

    polymyositis is a systemic autoimmune disorder characterised by proximal muscle weakness which most frequently involves the limbs, neck and trunk. Alpha interferon is an antiviral molecule with well-known immunomodulatory and antiproliferative effects, but its use is often associated with a variety of side effects, in particular autoimmune phenomena. We report the occurrence of polymyositis during treatment with alpha-interferon in a patient affected by malignant melanoma. Indirect evidence suggests that in this case the patient's myositis was not linked to her neoplasia, since the melanoma was confirmed to be in remission both at the time of the diagnosis of the muscle disease and again after more than one year of follow-up.
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keywords = neck
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7/148. Primary malignant melanoma arising in the parotid gland: case report and literature review.

    melanoma of the head and neck is an extremely rare disease, characterized by difficult and late diagnosis and poor prognosis; moreover, the definition of primary melanomas of the salivary glands remains controversial. In this paper we describe an unusual case of primary melanoma arising in the parotid gland. A 60-year-old woman presented to us for the persistence of a parotid neoplasm diagnosed as carcinoma by fine-needle aspiration and treated with radiation therapy. Wide destructive surgery was performed and immunohistochemical analysis of the surgical specimen led to a diagnosis of melanoma. Complete screening excluded other primary tumor sites. After five years of follow-up the patient Is alive and free of disease. Here we report the diagnostic procedures leading to the diagnosis along with a critical analysis of the literature, emphasizing the difficulties in the diagnosis and classification of melanoma as a primary tumor in the parotid gland and the need for destructive surgery.
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8/148. sentinel lymph node biopsy for melanoma in young children.

    lymphoscintigraphy and sentinel lymph node biopsy techniques can be applied successfully to young children with melanoma to detect nodal disease. The authors describe their methods of lymphoscintigraphy and sentinel node biopsy and its application in 2 young children with malignant melanoma of the head and neck.
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9/148. The platysma muscle in neck dissection.

    Although the platysma muscle is usually preserved during neck dissection, removal of this muscle is generally considered inconsequential. The present case report shows that sacrifice of the cervical branch of the facial nerve innervating this muscle and removal of the platysma's upper portion impairs the caudal retraction and eversion of the ipsilateral half of the lower lip in grinning or laughing.
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10/148. Malignant melanoma in a burn scar.

    Cancers of various sorts are occasionally encountered in burn scars. These lesions are usually squamous cell carcinomas, and the burn scars are usually old. Very rarely, malignant melanoma is encountered. An 87-year-old nursing home patient who had been burned by a lightening strike at age 16 was evaluated. She had sustained a wound covering 2% or 3% of her body surface involving her neck and the upper portion of her anterior trunk that had required several grafts. A lesion was noted over the suprasternal notch approximately 3 months before admission. The biopsy was reported as malignant melanoma. She was subsequently treated by wide reexcision with an associated Z-plasty for neck release. Because of the patient's age and the presence of four areas of regional lymph nodes nearby into which metastasis might spread, no lymph node dissections were carried out. The specimen from the reexcision was reported as squamous cell carcinoma in situ, melanoma in situ, and multinucleated giant cell reaction, acute and chronic infiltrates. The wound margins were clear.
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