1/121. Primary anorectal malignant melanoma: report of a case.Primary anorectal malignant melanoma is a fairly uncommon but highly malignant disease. This disease is sometimes mistaken for such benign conditions as either a hemorrhoid or rectal polyp. We herein describe a case of early primary malignant melanoma of the anal canal. In this case, magnetic resonance (MR) imaging was found to be useful for diagnosing the melanotic melanoma. We especially emphasize the usefulness of a fat-saturation MR image in distinguishing melanotic melanoma from other rectal tumors.- - - - - - - - - - ranking = 1keywords = canal (Clic here for more details about this article) |
2/121. Primary melanocytoma arising from the thoracic leptomeninges case.Primary melanocytoma arising from the leptomeninges of the spinal cord is very rare. A surgical specimen of a thoracic meningeal tumor was resected from a 75-year-old woman complaining of gait disturbance was investigated. magnetic resonance imaging and myelography showed a dumb-bell-type tumor in the subdural space at the 1st to 2nd thoracic vertebrae. The tumor was subtotally resected because of adhesion to the lamina and thoracic medulla. The localized, gelatinous black tumor showed a well-defined margin without dissemination or infiltration. The tumor had a thin capsule and was composed of solid proliferation of neoplastic melanocytes. Neither whorl formation nor foci of palisaded nuclei were observed. The neoplastic cells were of two major types: an epithelioid- or polygonal-shaped type and a spindle-shaped type, and had a large nucleus, a prominent nucleolus, coarse chromatin, and melanin-pigments in their cytoplasm. Only a few mitotic figures were observed. They were positive for HMB-45 and S-100 protein. This case was considered to be primary melanocytoma arising from the thoracic leptomeninges.- - - - - - - - - - ranking = 2.347282330293keywords = spinal (Clic here for more details about this article) |
3/121. breast carcinoma diverging to aberrant melanocytic differentiation: a case report with histopathologic and loss of heterozygosity analyses.A case of primary breast cancer showing differentiation to malignant melanoma is reported. To obtain insight into the clonal relationship between the two components of the tumor, polymerase chain reaction-based microsatellite analysis to detect loss of heterozygosity on chromosome arms 1p, 1q, 3q, 4q, 6q, 8p, 9p, 10q, 11q, 13q, 16q, 17p, 17q, and 18q with microdissected tissues of both components was performed in addition to histologic, histochemical, immunohistochemical, and ultrastructural techniques. The tumor consisted of a combination of carcinoma and melanoma with morphologic transition. Metastases in the lymph nodes and thoracic spinal bone marrow showed dual tissue structure. One of the metastatic lung tumors showed melanomatous tissue structure. The abundant pigment in the cells was positive for Fontana-Masson staining and bleached with potassium permanganate. The carcinoma component was positive for epithelial membrane antigen and CA19-9, but the melanoma component was negative. Conversely, the melanoma component was positive for HMB45 and vimentin, but the carcinoma component was negative. Electron microscopic analysis showed premelanosomes and melanosomes in the melanoma component. Microsatellite analysis showed the same genetic alterations with loss of heterozygosity on chromosome arms 1p, 3q, 4q, 6q, 9p, 10q, 11q, 13q, 16q, 17p, and 17q in in situ, invasive, and metastatic foci. We concluded that the carcinoma and melanoma components had arisen from the same clone and that this breast carcinoma might have diverged to aberrant malignant melanoma through multiple genetic alterations in the early period of ductal carcinoma in situ.- - - - - - - - - - ranking = 2.347282330293keywords = spinal (Clic here for more details about this article) |
4/121. Intraocular melanoma spread to regional lymph nodes: report of two cases.PURPOSE: To report two cases of regional lymphatic spread of primary uveal melanoma. methods: The clinical records of two patients who underwent enucleation for uveal melanoma and later developed regional lymph node metastases were reviewed. One of the two eyes was initially treated with proton beam irradiation. Histologic sections of the enucleated eyes and excised lymph nodes were examined. RESULTS: The melanomas arose in the choroid and ciliary body of the two patients and spread to regional lymph nodes 2 years after enucleation. The choroidal melanoma recurred after irradiation, diffusely infiltrated the uveal tract, and extended into the conjunctiva via an emissary canal. The ciliary body melanoma spread through the trabecular meshwork to the conjunctiva. CONCLUSIONS: Choroidal and ciliary body melanoma may rarely exhibit regional lymph node metastasis. This mode of metastasis may occur after extraocular spread and invasion of conjunctival lymphatics.- - - - - - - - - - ranking = 1keywords = canal (Clic here for more details about this article) |
5/121. Adjuvant interstitial brachytherapy in a case of anorectal melanoma.PURPOSE: A locally resectable case of anorectal melanoma is reported. In order to prevent local recurrence, interstitial brachytherapy was used. METHOD: A 45 years old emaciated female presented with a 8 x 6 x 6 cm, hard, mobile, intraluminal mass in the anal canal and rectum, biopsy revealed malignant melanoma. As the mass was locally resectable, wide local excision of the tumour was carried out. She was subsequently given interstitial brachytherapy with Caesium--137 implants at tumour bed, not described so far in literature. Six months later her general condition had improved but abdomino-perineal resection was necessitated due to presence of extra-rectal metastasis. RESULTS: Patient is in our follow-up for 36 months now and doing well. CONCLUSION: Supplementation of interstitial brachytherapy after local resection of ano-rectal melanoma may help to prevent local recurrence.- - - - - - - - - - ranking = 1keywords = canal (Clic here for more details about this article) |
6/121. epidural abscess: case report and literature review.OBJECTIVE: To report a case of spinal epidural abscess complicating epidural analgesia, and to heighten awareness of the condition and the importance of early recognition and treatment. CASE REPORT: A 72-year-old woman underwent adrenalectomy and groin dissection for recurrent malignant melanoma under combined general and epidural anesthesia. On the fourth postoperative day, she developed signs of localized infection at the epidural site and a band of reduced sensation. Further neurological signs developed before the diagnosis was made by magnetic resonance imaging scan. She subsequently underwent emergency laminectomy and drainage of epidural abscess. CONCLUSION: delayed diagnosis allowed the development of significant morbidity before neurosurgical intervention and antibiotics were instituted.- - - - - - - - - - ranking = 2.347282330293keywords = spinal (Clic here for more details about this article) |
7/121. Preservation of olfaction in anterior skull base surgery.OBJECTIVES/HYPOTHESIS: In selected unilateral tumors and defects of the anterior skull base, the preservation of contralateral olfaction is achievable through a localized subcranial approach without compromising surgical objectives of resection or repair. STUDY DESIGN: Description of a functional adaptation of anterior skull base surgical techniques through a retrospective patient series. methods: Nine patients underwent anterior skull base surgery for unilateral cribriform plate disease including four malignant and two benign tumors, two encephaloceles, and one iatrogenic cribriform injury with cerebrospinal rhinorrhea. All nine patients consented to a localized subcranial approach to the anterior skull base to preserve the contralateral olfactory nerves. In four patients with benign disease a portion of the ipsilateral nerves was additionally conserved. Postoperative olfaction was assessed objectively with a commercially available smell test. Indications, technique, results, and complications are reported and discussed. RESULTS: All patients had eradication of disease with preservation of functional olfaction CONCLUSIONS: Conservation of olfaction is possible in selected cases of anterior skull base surgery when the lesion is unilaterally confined.- - - - - - - - - - ranking = 2.347282330293keywords = spinal (Clic here for more details about this article) |
8/121. Intracranial and intraspinal meningeal melanocytosis.We describe a 35-year-old man with a history of remote closed head injury who presented with new neurologic deficits. A noncontrast head CT scan showed hyperattenuation involving both temporal lobes, frontal lobes, basal meninges, and cerebellum. A subsequent contrast-enhanced MR examination of the brain showed enhancement in the basal cisterns extending into the upper cervical spine and throughout the spinal canal. Gross, histologic, and immunohistochemical analysis revealed meningeal melanocytoma.- - - - - - - - - - ranking = 12.736411651465keywords = spinal, canal (Clic here for more details about this article) |
9/121. Primary spinal melanoma: case report.We report a case of primary melanoma of the thoracic spinal cord revealed by progressive bilateral lower extremity weakness associated with sensory loss and urinary dysfunction. The preoperative MRI revealed an intramedullary tumour from T7 to T9. Treatment was by complete surgical excision without radiotherapy. Histopathology and immuno-histochemical studies confirmed the diagnosis. The postoperative course was satisfactory with no sign of recurrence after 28 months of postsurgical follow-up. Primary spinal melanomas are rare intramedullary tumours that can be cured by appropriate surgical treatment.- - - - - - - - - - ranking = 14.083693981758keywords = spinal (Clic here for more details about this article) |
10/121. Primary intraspinal cervical melanoma.A case of primary intraspinal melanoma is presented. This is a very rarely observed lesion, as only 37 cases have been described up to now. Patient presenting with signs and symptoms of spinal cord compression after MRI and spinal angiography was operated upon. Total removal of an intraspinal cervical tumour was performed. Histopathological investigation confirmed melanoma. Subsequent radiotherapy was given. Follow up of 4 years duration showed no signs of recurrence in MRI and full motor and sensory recovery.- - - - - - - - - - ranking = 18.778258642344keywords = spinal (Clic here for more details about this article) |
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