The author reports herein two cases of amelanotic malignant melanoma of the esophagus. Case 1 is an 87-year-old woman who was admitted to our hospital because of nausea and vomiting. Endoscopic examination revealed an...The author reports herein two cases of amelanotic malignant melanoma of the esophagus. Case 1 is an 87-year-old woman who was admitted to our hospital because of nausea and vomiting. Endoscopic examination revealed an ulcerated tumor of the distal esophagus, and a biopsy was taken. The biopsy showed malignant polygonal and spindle cells. No melanin pigment was recognized. Immunohistochemically, the tumor cells were positive for melanosome （HMB45）, S100 protein, KIT and Platelet derived growth factor receptor-α （PDG- FRA）. The patient was treated by chemotherapy and radiation, but died of systemic metastasis 12 mo after the presentation. Case 2 is a 56-year-old man presenting with dysphagia. Endoscopic examination revealed a polypoid tumor in the middle esophagus, and a biopsy was obtained. The biopsy showed malignant spindle cells without melanin pigment. Immunohistochemically, the tumor cells were positively labeled for melanosome,S100 protein, KIT and PDGFRA. The patient refused operation, and was treated by palliative chemotherapy and radiation. He died of metastasis 7 mo aEer the admission. In both cases, molecular genetic analyses of gene （exons 9, 11, 13 and 17） and PDGFRA gene （exons 12 and 18） were performed by the PCR direct sequencing method, which showed no mutations of KIT and PDGFRA genes. This is the first report of esophageal malignant melanoma with an examination of the expression of KIT and PDGFRA and the mutational status of K/T and PDGFRA genes.展开更多
BACKGROUND Primary malignant melanoma of the esophagus accounts for 0.1%-0.2%of all esophageal malignancies,including melanotic and amelanotic melanomas.Primary amelanotic malignant melanoma of the esophagus is extrem...BACKGROUND Primary malignant melanoma of the esophagus accounts for 0.1%-0.2%of all esophageal malignancies,including melanotic and amelanotic melanomas.Primary amelanotic malignant melanoma of the esophagus is extremely rare,and only about 20 cases have been published in the literature to date.Most primary malignant melanomas of the esophagus are diagnosed following development of metastatic lesions and thus have a very poor prognosis.The median survival duration of patients with metastatic melanoma has been reported to be 6.2 mo.CASE SUMMARY A 49-year-old woman was referred to our hospital with a diagnosis of esophageal cancer.Endoscopy,biopsy,imaging evaluation,and physical examination at our hospital indicated a diagnosis of advanced primary amelanotic malignant melanoma of the esophagus.Immunohistochemical staining confirmed melanoma.Nuclear medicine examination revealed a left iliac bone metastatic lesion.After discharge,the patient self-administered apatinib for 3 mo,followed by oral treatment with Chinese medicines(also self-administered)for 2 mo.No treatments had been taken since then.The patient has survived with no growth out to the most recent follow-up(24 mo post diagnosis),and she always presented with a positive attitude about her condition during this period.CONCLUSION Survival following metastatic melanoma might be related to the pharmaceutical and Chinese medicine treatment and the patient's positive attitude.展开更多
Introduction Malignant melanoma （MM） is one of the most deadly cancerst. Although the disease accounts for only about 4% of skin cancer related cases, it is responsible for about 79% of skin cancer deaths. Early dia...Introduction Malignant melanoma （MM） is one of the most deadly cancerst. Although the disease accounts for only about 4% of skin cancer related cases, it is responsible for about 79% of skin cancer deaths. Early diagnosis of MM is, therefore, essential for appropriate treatment decision and, in turn, may give patients the best chance for prolonged survival. About 6% to 8% of malignant melanomas lack typical pigmentation and tend to be managed as benign lesions, making accurate early diagnosis difficultt61. Though subungual MM is rare,展开更多
To investigate the ultra structure of amelanotic melanocytes （AMMC）. Methods： The hair follicles obtained from normal human scalp by 0.50% collagenase type V treatment were washed with 0.1 mol/L phosphate buffer sa...To investigate the ultra structure of amelanotic melanocytes （AMMC）. Methods： The hair follicles obtained from normal human scalp by 0.50% collagenase type V treatment were washed with 0.1 mol/L phosphate buffer salt （PBS）. Hair-follicle cell suspensions were prepared by trypsin treatment and cultured in melanocyte medium. Remaining keratinocytes were removed by differential trypsinization. 100μg/ml geneticin was used to eliminate the contaminating fibroblasts. At third passage, the cells were trypsinized, and then washed in phosphate-buffered saline and processed for transmission electron microscopy. Results： Under transmission electron microscope, the cultured cells showed round or oval shape, with single large nuclear and the karyotheca were double deck. There were obvious euchromosome within the nucleus, and sparse heterochromosome. There were various organelles in the cytoplasm, including plentiful melanosomes with nearly similar size, mitochondria, rough endoplasmic reticule （RER） and ribosome. The electron density granules in most of the melanosomes disposed along concentric circularities. Golgi apparatus in the cells was inconspicuous. Conclusion： The ultra structure of AMMC from human hair follicles is different from that of epidermal melanocytes, and these characteristics determine the functional immature of AMMC.展开更多
BACKGROUND Anorectal melanoma (AM) is an extremely rare malignant tumor originating from anorectal melanocytes with a poor prognosis. AM has been reported to have a much lower incidence than cutaneous or choroid melan...BACKGROUND Anorectal melanoma (AM) is an extremely rare malignant tumor originating from anorectal melanocytes with a poor prognosis. AM has been reported to have a much lower incidence than cutaneous or choroid melanoma, accounting for 0.4%-1.6% of all melanomas. CASE SUMMARY We report a 76-year-old female patient diagnosed with anorectal malignant melanoma by colonoscopy and biopsy. Intraoperative examination revealed two distinct anorectal tumors, one melanotic and another amelanotic, as well as two pigmented mucosal zones at the dentate line level. Abdominal perineal resection was performed. A pathological report confirmed all four lesions to be melanomas. Postoperatively, we followed an immunotherapy protocol targeting PD-1 (nivolumab). The patient had 24 mo of disease-free follow-up upon completion of nivolumab treatment. CONCLUSION This is the first reported case presenting coexistence of pigmented and unpigmented AMs in the same patient.展开更多
文摘The author reports herein two cases of amelanotic malignant melanoma of the esophagus. Case 1 is an 87-year-old woman who was admitted to our hospital because of nausea and vomiting. Endoscopic examination revealed an ulcerated tumor of the distal esophagus, and a biopsy was taken. The biopsy showed malignant polygonal and spindle cells. No melanin pigment was recognized. Immunohistochemically, the tumor cells were positive for melanosome （HMB45）, S100 protein, KIT and Platelet derived growth factor receptor-α （PDG- FRA）. The patient was treated by chemotherapy and radiation, but died of systemic metastasis 12 mo after the presentation. Case 2 is a 56-year-old man presenting with dysphagia. Endoscopic examination revealed a polypoid tumor in the middle esophagus, and a biopsy was obtained. The biopsy showed malignant spindle cells without melanin pigment. Immunohistochemically, the tumor cells were positively labeled for melanosome,S100 protein, KIT and PDGFRA. The patient refused operation, and was treated by palliative chemotherapy and radiation. He died of metastasis 7 mo aEer the admission. In both cases, molecular genetic analyses of gene （exons 9, 11, 13 and 17） and PDGFRA gene （exons 12 and 18） were performed by the PCR direct sequencing method, which showed no mutations of KIT and PDGFRA genes. This is the first report of esophageal malignant melanoma with an examination of the expression of KIT and PDGFRA and the mutational status of K/T and PDGFRA genes.
文摘BACKGROUND Primary malignant melanoma of the esophagus accounts for 0.1%-0.2%of all esophageal malignancies,including melanotic and amelanotic melanomas.Primary amelanotic malignant melanoma of the esophagus is extremely rare,and only about 20 cases have been published in the literature to date.Most primary malignant melanomas of the esophagus are diagnosed following development of metastatic lesions and thus have a very poor prognosis.The median survival duration of patients with metastatic melanoma has been reported to be 6.2 mo.CASE SUMMARY A 49-year-old woman was referred to our hospital with a diagnosis of esophageal cancer.Endoscopy,biopsy,imaging evaluation,and physical examination at our hospital indicated a diagnosis of advanced primary amelanotic malignant melanoma of the esophagus.Immunohistochemical staining confirmed melanoma.Nuclear medicine examination revealed a left iliac bone metastatic lesion.After discharge,the patient self-administered apatinib for 3 mo,followed by oral treatment with Chinese medicines(also self-administered)for 2 mo.No treatments had been taken since then.The patient has survived with no growth out to the most recent follow-up(24 mo post diagnosis),and she always presented with a positive attitude about her condition during this period.CONCLUSION Survival following metastatic melanoma might be related to the pharmaceutical and Chinese medicine treatment and the patient's positive attitude.
基金supported by a grant from the Program for Changjiang Scholars and by the Innovative Research Team in University,Ministry of Education,China (No.IRT0760)
文摘Introduction Malignant melanoma （MM） is one of the most deadly cancerst. Although the disease accounts for only about 4% of skin cancer related cases, it is responsible for about 79% of skin cancer deaths. Early diagnosis of MM is, therefore, essential for appropriate treatment decision and, in turn, may give patients the best chance for prolonged survival. About 6% to 8% of malignant melanomas lack typical pigmentation and tend to be managed as benign lesions, making accurate early diagnosis difficultt61. Though subungual MM is rare,
文摘To investigate the ultra structure of amelanotic melanocytes （AMMC）. Methods： The hair follicles obtained from normal human scalp by 0.50% collagenase type V treatment were washed with 0.1 mol/L phosphate buffer salt （PBS）. Hair-follicle cell suspensions were prepared by trypsin treatment and cultured in melanocyte medium. Remaining keratinocytes were removed by differential trypsinization. 100μg/ml geneticin was used to eliminate the contaminating fibroblasts. At third passage, the cells were trypsinized, and then washed in phosphate-buffered saline and processed for transmission electron microscopy. Results： Under transmission electron microscope, the cultured cells showed round or oval shape, with single large nuclear and the karyotheca were double deck. There were obvious euchromosome within the nucleus, and sparse heterochromosome. There were various organelles in the cytoplasm, including plentiful melanosomes with nearly similar size, mitochondria, rough endoplasmic reticule （RER） and ribosome. The electron density granules in most of the melanosomes disposed along concentric circularities. Golgi apparatus in the cells was inconspicuous. Conclusion： The ultra structure of AMMC from human hair follicles is different from that of epidermal melanocytes, and these characteristics determine the functional immature of AMMC.
文摘BACKGROUND Anorectal melanoma (AM) is an extremely rare malignant tumor originating from anorectal melanocytes with a poor prognosis. AM has been reported to have a much lower incidence than cutaneous or choroid melanoma, accounting for 0.4%-1.6% of all melanomas. CASE SUMMARY We report a 76-year-old female patient diagnosed with anorectal malignant melanoma by colonoscopy and biopsy. Intraoperative examination revealed two distinct anorectal tumors, one melanotic and another amelanotic, as well as two pigmented mucosal zones at the dentate line level. Abdominal perineal resection was performed. A pathological report confirmed all four lesions to be melanomas. Postoperatively, we followed an immunotherapy protocol targeting PD-1 (nivolumab). The patient had 24 mo of disease-free follow-up upon completion of nivolumab treatment. CONCLUSION This is the first reported case presenting coexistence of pigmented and unpigmented AMs in the same patient.
