Cases reported "Skin Neoplasms"

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1/1010. melanosis in association with metastatic malignant melanoma: report of a case and a unifying concept of pathogenesis.

    An unusual case of melanosis associated with metastatic malignant melanoma is reported. This was characterized by progressive blue/gray discoloration of the skin of the chest and abdomen in an elderly patient, 1 year after removal of a polypoid malignant melanoma from the right arm. A biopsy of involved skin revealed perivascular aggregates of melanin-laden histiocytes throughout the dermis, the histopathologic hallmark of melanosis. An unusual aspect of the case was the coincidental finding of a tumor embolus within a small dermal vessel, probably a lymphatic. To date, neoplastic melanocytes have been detected in only a small minority of skin biopsies with features of melanosis. This case and a distillation of related information in the literature lead to the conclusion that the essence of melanosis, and the feature that distinguishes this from conventional metastatic melanoma, is the persistent and cumulative dissemination of melanin, via the bloodstream, throughout the body. This in turn leads to progressive pigmentation of all internal organs and the skin. Only continuous access to the circulation by neoplastic melanocytes could explain such a phenomenon. Potential mechanisms by which this could arise are discussed in the context of existing knowledge.
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ranking = 1
keywords = lymphatic
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2/1010. Metastatic melanoma to the skin simulating blue nevus.

    Cutaneous metastases from melanoma can mimic primary melanoma and melanocytic nevi. Recognition of a metastatic lesion is of great importance for proper staging and treatment decisions. In this study, a potential diagnostic pitfall is described and discussed: dermal metastases from cutaneous melanoma simulating blue nevus, a phenomenon that has received little attention. Ten blue nevus-like lesions from three patients are presented. All contained pigmented melanocytes and melanophages in variable proportions arranged in a blue nevus-like growth pattern. The blue nevus-like metastases occurred in the same anatomic region as the primary tumor or, as in one patient, near the skin scar of a dissected lymph node metastasis. Histologic clues of metastatic melanoma included the presence of atypical epithelioid melanocytes, mitotic figures, and an associated inflammatory cell infiltrate at the periphery of the lesion. Although such histologic features facilitate the recognition of a metastasis, clinical correlation is essential for a definitive diagnosis.
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ranking = 35.492838415348
keywords = metastasis
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3/1010. Inflammatory metastatic melanoma.

    An 87-year-old woman developed erythema, induration and tenderness of the skin overlying each breast. One year before, she had undergone an axillary lymph node dissection because of metastases from melanoma. The primary site was unknown. A skin biopsy showed pigmented tumor nests within the dermal lymphatic vessels, and immunohistochemistry confirmed the melanocytic origin. The diagnosis of inflammatory metastatic melanoma was made.
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ranking = 1
keywords = lymphatic
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4/1010. Papillary formations in metastatic melanoma.

    Cytomorphologic features of melanoma can be extremely variable, in that they can mimic other poorly differentiated neoplasms. Ten cases of metastatic melanoma with distinct, cohesive, papillary tissue fragments observed in fine-needle aspiration (FNA) specimens are reported. These papillary fragments exhibited a central fibrovascular core with attached tumor cells, in a background of single scattered malignant cells, macrophages, and focal necrosis. The aspiration sites included regional or distant palpable lymph nodes, pancreas, bone, and skin. Nine cases had a histologic diagnosis of primary cutaneous melanoma, and in one case the primary skin tumor was detected after the diagnosis was established by FNA of the metastasis. Immunohistochemical studies (S-100 protein, HMB-45 antigen, and factor viii) were performed in four cases, and electron microscopy in one, confirming the diagnosis of melanoma. An awareness of this cytomorphologic variation of papillary formations in cytology preparations from metastatic melanoma is important and can prevent potential inaccurate interpretation.
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ranking = 17.746419207674
keywords = metastasis
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5/1010. Leiomyosarcomatosis involving the duodenum and the subcutaneous tissue.

    Soft tissue sarcomas include only 0.7% of all malignancies and leiomyosarcomas constitute about 10% of all sarcomas. Very rarely leiomyosarcoma may present as multifocal primaries. We report a 65-year-old patient with multiple subcutaneous nodules. During the investigation period the patient had hematemesis and melena. Upper gastro-intestinal endoscopy was performed and multiple polipoid lesions were discovered in the duodenum. The rest of gastrointestinal system was normal with barium graphies. Biopsies from the subcutaneous nodules and duodenal lesions showed leiomyosarcoma. Although we cannot rule out the possibility of metastases, we strongly consider a multicentric origin since no other metastasis is present and duodenal lesions are also multiple.
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ranking = 17.746419207674
keywords = metastasis
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6/1010. A case of a malignant melanoma with late metastases 16 years after the initial surgery.

    We report a case of a pulmonary metastasis 16 years after the initial surgery for a malignant melanoma. The patient was a 58-year-old Japanese man. In 1976, he had a pigmented skin lesion with a diameter of 8 mm on his right third finger. He received an amputation of the finger and a dissection of the right axillary. Histological examinations of the tumor revealed a feature of a malignant melanoma with infiltration of the papillary layers of the dermis, 1.5 mm in thickness. The histological subtype was considered to be an acral lentiginous melanoma with a mixed spindle-epithelioid cell pattern. There was no regional lymph node metastasis. In December 1992, when he was 74-years-old, a round tumor in the left lower lung was discovered by chest radiography. In February 1993, he received a left lower lobectomy of the lung. Histological examination revealed a feature of a malignant melanoma with predominantly epithelioid cells and this was considered to be a metastasis from the initial skin lesion. Five months after the lobectomy, he died from a hemorrhage of a metastatic brain tumor. This case indicated the importance of periodic, life-long follow-up in treating malignant melanomas.
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ranking = 53.239257623022
keywords = metastasis
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7/1010. Basal cell carcinoma with lung metastasis diagnosed by fine-needle aspiration biopsy.

    Basal cell carcinoma of the skin is one of the most common types of cancer. Its natural history is one of local recurrence rather than metastatic spread. Certain histologic features and primary tumor size seem to be risk factors for metastases. The diagnosis of metastatic disease imparts a poor prognosis with a short median survival. Treatment is usually in the form of systemic chemotherapy with cisplatin-based combination described as most active agent.
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ranking = 70.985676830696
keywords = metastasis
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8/1010. Specific skin lesions occurring in a patient with Hodgkin's lymphoma.

    A 47-year-old man presented with a several month history of non-specific acquired ichthyosis, an unknown period of generalized lymphadenopathy and a short history of erythematous papules and nodules affecting the cutaneous drainage area of his right axillary lymph nodes. histology confirmed these lesions to be specific lesions of Hodgkin's lymphoma; that is, metastatic retrograde lymphatic spread from his axillary lymph nodes of CD30 , CD15 , reed-sternberg cells as well as mononuclear Hodgkin's cells. This is the most common site and mode of spread of Hodgkin's disease to the skin. As is typical of advanced Hodgkin's disease, as evidenced by specific cutaneous involvement, this patient died shortly after definitive diagnosis was made.
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ranking = 1
keywords = lymphatic
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9/1010. Primary adenoid cystic carcinoma of skin with lung metastasis.

    Primary cutaneous adenoid cystic carcinoma was first reported in 1975. We report a case of this malignancy with pulmonary metastases in a 70-year-old man and offer a brief review of the literature.
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ranking = 70.985676830696
keywords = metastasis
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10/1010. Long-term survival after extended surgical resection of melanoma metastasis and immunotherapy.

    A patient with a huge melanoma metastasis to the left adrenal gland was treated by multivisceral surgical resection. Progression of disease could be controlled by systemic immunotherapy resulting in long-term survival. In selected cases, above all with late manifestation of distant melanoma metastases, even major surgical resection of such lesions can be worthwhile.
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ranking = 88.73209603837
keywords = metastasis
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