1/7. 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.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/7. Enteric duplication cyst associated with melanosis peritonei.melanosis peritonei is usually associated with benign cystic teratomas of the ovary. We describe a one-and-a-half-year-old girl with melanosis peritonei associated with enteric duplication cyst. Melanophages were seen in aggregates in and around the serosal blood vessels, nerve bundles, and scattered within the muscular wall of the cyst. Presence of hyperplastic nerve bundles associated with melanophages suggests their origin from the neural crest.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/7. Acquired dermal melanocytosis: a case with conjunctival and gingival pigmentation.A 28-year-old Japanese woman was referred to us because of widespread bilateral blue-gray and brown pigmentation on her face. Pigmentation was apparant on both sclerae, the alae of the nose, the lower lip and the gingiva; and it was also evident on her extremities. A biopsy specimen revealed melanin-containing cells and numerous mononulear cells in the upper dermis, particularly, near the small vessels. The melanin-containing cells immunoreacted with S100-specific antibodies but did not react with CD68-specific antibodies, these observations indicated that they were melanocytes. A diagnosis was made of acquired dermal melanocytosis (ADM), even though ADM is very rarely associated with conjunctival and mucosal involvement. Dermal melanocytes and large numbers of mononuclear cells adjacent to small vessels in the upper dermis have not previously been reported in ADM. Such melanocytes might play an important role in protecting blood cells from ultraviolet light. The presence of mononuclear cells close to melanocytes suggests that an inflammatory reaction might have initiated the activation of these dermal melanocytes.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
4/7. Two discrete uveal melanomas in a child with ocular melanocytosis.OBJECTIVE: To describe a case of two uveal melanomas in a child with mild ocular melanocytosis. methods: A 6-year-old girl was followed for 5 years with an ill-defined, slowly enlarging presumed choroidal nevus in the postequatorial fundus. Ocular oncology evaluation revealed mild sectorial scleral and uveal melanocytosis and an episcleral sentinel vessel superotemporally. Two discrete uveal melanomas were present. In the circumpapillary and macular region, tumor 1 was diffuse at 9.0 mm in base and 4.1 mm in thickness and with overlying subretinal fluid. In the ciliary body, tumor 2 was discovered by transillumination and was 6.0 mm in base and 2.2 mm in thickness. Enucleation was performed. RESULTS: Histopathologic analysis disclosed two discrete uveal melanomas in a bed of diffuse mild uveal melanocytosis. Tumor 1 was a mixed, predominantly epithelioid cell melanoma with active mitotic figures, and tumor 2 was a mixed, predominantly spindle cell melanoma. The choroid between the melanomas showed only benign, dendritic melanocytes consistent with melanocytosis. There was no extrascleral extension. CONCLUSIONS: Ocular melanocytosis can predispose to one or multiple uveal melanomas. Lifetime ophthalmic monitoring of affected patients is warranted.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/7. Pathogenesis of generalized melanosis with melanuria and melanoptysis secondary to malignant melanoma.A case of disseminated malignant melanoma with generalized melanosis of the skin and other tissues, melanuria, melanoptysis, and a dark brown blood serum is reported. The reticuloendothelial system contained large amounts of melanin pigment. Lysis of degenerating pigment-loaded melanoma cells in peripheral blood vessels seemed to be of considerable importance in the pigmentation of tissues. Focal pigmentation of capillary endothelium and perivascular deposition of melanin pigment in macrophages and, occasionally contained large amounts of melanin pigment. Lysis of degenerating pigment-loaded melanoma cells in peripheral blood vessels seemed to be of considerable importance in the pigmentation of tissues. Focal pigmentation of capillary endothelium and perivascular deposition of melanin pigment in macrophages and, occasionally contained large amounts of melanin pigment. Lysis of degenerating pigment-loaded melanoma cells in peripheral blood vessels seemed to be of considerable importance in the pigmentation of tissues. Focal pigmentation of capillary endothelium and perivascular deposition of melanin pigment in macrophages and, occasionally, in other cells, was noted. Single cell metastases contributed to melanin pigmentation of most organs, but were not found in sections of the skin. Melanoptysis (black sputum) was due to diffuse melanoma cell infiltration of the lungs, with secondary pigment deposition in macrophages and in bronchial epithelial cells. In this case the 'glomerular melanoma cell emboli' recorded by previous authors consisted of melanin pigment and cell debris. Focal damage of glomeruli affected by pigment emboli is described allowing access of melanoma cell debris (including melanin pigment granules) into glomerular tubules.- - - - - - - - - - ranking = 3keywords = vessel (Clic here for more details about this article) |
6/7. Erythromelanosis follicularis faciei et colli. case reports.Erythromelanosis follicularis of the face and neck has seldom been described in the literature. It is a condition of unknown aetiology. The clinical features are reddish-brown pigmentation, telangiectatic vessels, and pale follicular papules localized in the peri-auricular area. The disease is asymptomatic and has only been described in men. This report records two patients with erythromelanosis follicularis of the face and neck, a boy and a young adult female.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/7. Generalized melanosis in metastatic malignant melanoma: the possible role of DOPAquinone metabolites.Generalized melanosis occurs very rarely as a complication of malignant melanoma, and the pathogenesis of this condition is still unclear. Histological examination of pigmented skin and measurements of the DOPAquinone metabolites 5-S-cysteinyldopa (5-S-CD) and 6-hydroxy-5-methoxyindole-2-carboxylic acid (6H5MI2C) in the patient's serum and urine were carried out. Histological examination revealed basal hyperpigmentation, discrete melanoma cells and melanophages around the blood vessels and an unusual melanin deposition within collagen bundles in the dermis. The levels of 5-S-CD and 6H5MI2C were dramatically increased both in the patient's serum and urine. The deposition of DOPAquinone metabolites secreted by the melanoma cells may contribute to the unusual melanin deposition within collagen bundles in the affected dermis.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |