OBJECTIVETo summarize the clinicopathological characteristics of primary anorectal malignant melanoma (AMM).

METHODSClinical data of nine patients with AMM were reviewed retrospectively from January 1999 to March 2005.

RESULTSAnorectal malignant melanoma had a female predominance. The average age was 56 years old and average course of disease was 5.8 months. The onset of symptom was hematochezia, then anus prolapses. 94.7% of patients had AMM within 5 cm from anus margin; the average tumor size was (3.3+/- 2.1) cm. The polyp and ulcer were most common types. More than a half (54.5%) of the tumor was movable, 19.1% smooth surfaced, 6.6% soft textured. Synchronous metastasis was found in 14.0% of the patients, the first common metastasis was found in liver, the secondary was superficial inguinal lymph node metastasis. Half of the patients were misdiagnosed,and over 50% of patients were misdiagnosed as benign disease. Mile's operation was performed in most of patients (63%), while anal resection was performed in 30% of the patients.

CONCLUSIONSAnorectal malignant melanoma is often misdiagnosed,surgical procedure is the first choice for patients with AMM.

Adult ; Aged ; Aged, 80 and over ; Anus Neoplasms ; diagnosis ; pathology ; surgery ; Female ; Humans ; Male ; Melanoma ; diagnosis ; pathology ; surgery ; Middle Aged ; Rectal Neoplasms ; diagnosis ; pathology ; surgery ; Retrospective Studies

Malignant melanoma of the lacrimal sac is very rare and primary malignant melanoma is extremely rare. It is usually diagnosed at an advanced stage after excision or biopsy of a tumor. We treated a patient with tearing and bloody discharge from the left eye. We performed a dacryocystectomy with the suspicion of a chronic dacryocystitis. However, the pathological findings and the immunohistochemical studies showed a malignant melanoma of the lacrimal sac. The patient underwent postoperative irradiation therapy. Follow up two months after surgery revealed no evidence of recurrence. Early diagnosis is very important for prognosis in patients with malignant melanoma of the lacrimal sac. Because this tumor often presents with symptoms similar to dacryocystitis and may masquerade as a chronic dacryocystitis, it can be difficult to make an early diagnosis.
Tomography, X-Ray Computed ; Ophthalmologic Surgical Procedures/methods ; Middle Aged ; Melanoma/*diagnosis/surgery ; *Lacrimal Apparatus ; Humans ; Follow-Up Studies ; Female ; Eye Neoplasms/*diagnosis/surgery ; Diagnosis, Differential ; Biopsy

Aged ; Back ; Carcinoma, Medullary ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Humans ; Melanoma ; metabolism ; pathology ; secondary ; surgery ; Melanoma-Specific Antigens ; metabolism ; S100 Proteins ; metabolism ; Skin Neoplasms ; metabolism ; pathology ; surgery ; Thyroid Neoplasms ; metabolism ; pathology ; secondary ; surgery

Adult ; Diagnosis, Differential ; Humans ; MART-1 Antigen ; metabolism ; Magnetic Resonance Imaging ; Male ; Medulloblastoma ; metabolism ; pathology ; Melanocytes ; pathology ; Melanoma ; diagnosis ; metabolism ; pathology ; surgery ; Melanoma-Specific Antigens ; metabolism ; Meningeal Neoplasms ; diagnosis ; metabolism ; pathology ; surgery ; Neoplasms, Multiple Primary ; diagnosis ; metabolism ; pathology ; surgery ; Neurilemmoma ; metabolism ; pathology ; Nevus of Ota ; diagnosis ; metabolism ; pathology ; surgery ; S100 Proteins ; metabolism ; Skin Neoplasms ; diagnosis ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

OBJECTIVETo investigate the diagnosis and treatments of malignant melanoma in gastrointestinal tract.

METHODThe clinical data of 70 cases of malignant melanoma in gastrointestinal tract treated between July 1965 and June 2007 were collected and analyzed.

RESULTSThere were 27 male and 43 female patients in this group with a median age of 53 years. The melanoma arose from rectum in 50 cases, from anus in 10 cases and from esophagus in 10 cases. The overall 1, 3, 5 years survival rate were 48.3%, 14.6% and 6.5%, respectively, the median survival time was 379 days. Sixty-three cases received operations with or without adjuvant therapy after the operation. There was no significant differences in overall survival rate between the 25 cases received operation only (Group 1) and 38 cases supplemented by adjuvant therapy after operation (Group 2); whereas, the cases with clinical stage III tumor in Group 2 had significantly better survival than their counterparts in Group 1. It was found that the depth of tumor invasion was the risk factor of patient's prognosis on multivariate Cox regression analysis.

CONCLUSIONSOperation combined with adjuvant therapy can improve the survival of the patient with stage III melanoma in gastrointestinal tract. The depth of tumor invasion is a risk factor of survival in these patients.

Adult ; Aged ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Gastrointestinal Neoplasms ; diagnosis ; mortality ; surgery ; Humans ; Male ; Melanoma ; diagnosis ; mortality ; surgery ; Middle Aged ; Retrospective Studies ; Survival Analysis

BACKGROUNDAnorectal malignant melanoma was a rare disease with extremely poor prognosis. The aim of this study was to explore the clinical characteristic, diagnosis and treatment strategies of anorectal malignant melanoma.

METHODSThe data of 57 patients with anorectal malignant melanoma was collected and retrospectively analyzed.

RESULTSRectal bleeding and anal mass were found to be common symptoms of anorectal malignant melanoma. The preoperative diagnosis rate of anorectal malignant melanoma was 48.6%. The overall 3-year and 5-year survival rate was 38.0% and 21.3% respectively. The 3-year survival rates of stage I and II patients were 63.0% and 16.7% respectively (P = 0.000), and the 5-year survival rates were 33.3% and 11.1% (P = 0.001), which both had significant statistic differences. The 3-year survival rate of patients undergone abdmoninoperineal resection and patients undergone wide local excision were 36.7% and 53.0% respectively (P = 0.280), while the 5-year survival rate were 24.1% and 23.1% (P = 0.642), which both had no significant statistic differences.

CONCLUSIONSThis study identified no survival advantage to abdominoperineal resection in treatment of anorectal malignant melanoma, and we propose that wide local excision could be considered as the initial treatment of choice.

Adult ; Aged ; Aged, 80 and over ; Anus Neoplasms ; diagnosis ; mortality ; pathology ; surgery ; Female ; Humans ; Male ; Melanoma ; diagnosis ; mortality ; pathology ; surgery ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Survival Rate

BACKGROUNDCiliary body tumors are usually difficult to diagnose and treat in early stages. However, treatment of such tumors has trended toward ocular conservation instead of enucleation. Local excision of ciliary body tumors has become effective with the development of the modern vitrectomy, but long-term outcomes are still not clear. Therefore, we reported the outcome of locally excised ciliary body tumors after long-term follow-up.

METHODSTwenty-two patients (22 eyes), who had been diagnosed with ciliary body tumors in Beijing Tongren Hospital from January 1996 to June 2001, were enrolled in this prospective cohort study. Localized lamellar sclera-ciliary excisions were performed. In some cases, vitrectomies, scleral graft transplantations, and further excisions of the anterior choroid were performed. Diagnoses were confirmed by histopathologic examination. Patients were followed from five to eleven years after surgery. Their visual acuity, intraocular pressure and local recurrence were recorded with descriptive percentages.

RESULTSAfter surgery, all patients maintained normal eyeball appearances. Six patients maintained circular pupils. The final best corrected visual acuities (BCVA) varied from 0.02 - 1.00, including 18 patients (81.82%) who had BCVA equal to or better than that before surgery. Fifteen patients (68.18%) had BCVA better than 0.3. Only two patients had intraocular pressure (IOP) of less than 10 mmHg and the other patients maintained normal IOP. Nine cases (40.91%) were given confirmed diagnosis of malignant melanoma, four (18.18%) of melanocytoma, six (27.27%) of nonpigmented ciliary epithelial adenoma, two (9.09%) of neurofibroma, and one (4.55%) of neurinoma. Twenty patients (90.91%) had no recurrence during the follow-up period. In one case melanocytoma recurred seven years after surgery and enucleation was performed. One patient, whose operation removed a malignant melanoma with a diameter of 16 mm, died of hepatic metastasis five years after the operation.

CONCLUSIONFor some ciliary body tumors, especially in the early stages, local excision is an effective and safe method to save the vision and the eyeball.

Adolescent ; Adult ; Ciliary Body ; Cohort Studies ; Female ; Humans ; Intraocular Pressure ; Male ; Melanoma ; surgery ; Middle Aged ; Prospective Studies ; Uveal Neoplasms ; diagnosis ; pathology ; surgery ; Visual Acuity

Adolescent ; Diagnosis, Differential ; Endometriosis ; pathology ; Female ; Humans ; Melanoma ; pathology ; Melanosis ; complications ; pathology ; surgery ; Ovarian Neoplasms ; complications ; Peritoneal Diseases ; complications ; pathology ; surgery ; Teratoma ; complications

BACKGROUND: A retrospective study was conducted to review the overall survival and treatment outcomes of high grade melanoma in the extremity to explore the clinical features of malignant melanoma of the hand and foot, and the therapeutic efficacies and survival rate after amputation. METHODS: The clinical data of 30 patients with malignant melanoma of the hand and foot (confirmed by pathological examination), who were admitted and treated in our hospital between 2001 and 2010, were analyzed retrospectively. We analyzed variables affecting overall and disease-free survival. RESULTS: Thirty patients (18 men and 12 women) treated with an amputation procedure for malignant melanoma in the hand or foot constituted the study cohort. The average age of the patients at the time of diagnosis was 58.7 years. Univariate analysis for overall melanoma survival revealed that diagnosis at over 70 years of age, postoperative lymph node metastasis, and location of the tumor were significant prognostic factors. And on the Kaplan-Meier survival curve, old age, American Joint Committee on Cancer stage and postoperative lymph node metastasis showed statistically significant differences in the 5-year survival rate. Also, amputation with aggressive lymph node dissection showed improved long term survival in advanced stage melanoma. CONCLUSIONS: In Korean melanoma patients, for the treatment of high grade melanomas in the extremities after amputation, early diagnosis and postoperative follow-up for evaluation of lymph node metastasis are critical factors for long-term survival. And by performing lymph node dissection during amputation, we may improve the survival rate in advanced stage melanoma patients.
Aged ; *Amputation ; Analysis of Variance ; Disease-Free Survival ; Female ; Foot/*surgery ; Hand/*surgery ; Humans ; Kaplan-Meier Estimate ; Male ; Melanoma/diagnosis/pathology/*surgery ; Middle Aged ; Neoplasm Staging ; Prognosis ; Republic of Korea ; Retrospective Studies ; Skin Neoplasms/diagnosis/pathology/*surgery ; Survival Rate ; Treatment Outcome

Perivascular epithelioid cell tumor (PEComa) is extremely rare, which originated from mesenchymal cells in the intestine, and composed of histologically and immunohistochemically distinctive perivascular epithelioid cells. We report here on a case of PEComa in the sigmoid colon. A 62-year-old woman presented with hematochzia 10 days ago. Her abdominal computed tomography scan showed a 5 cm sized intraluminal fungating heterogeneously enhanced, high density mass, which infiltrated pericolic tissue surrounding the sigmoid colon. Colonoscopy showed a purple colored polypoid mass with lobulating contour in the sigmoid colon. She underwent laparoscopic anterior resection. On the histologic examination, the tumor consisted of polygonal epithelioid cells with sheet-like growth of nests, which looked like alveolar tissues in lung. The tumor cells were strongly positive stained with human melanoma black-45 (HMB-45). Pathologic examination was compatible with PEComa. Sixteen months after surgery, she did well without tumor recurrence after surgery. We review the literatures concerning PEComa of the intestine focusing on endoscopic findings.
Colonic Neoplasms/diagnosis ; Colonoscopy ; Female ; Gastrointestinal Hemorrhage ; Humans ; Melanoma-Specific Antigens/metabolism ; Middle Aged ; Perivascular Epithelioid Cell Neoplasms/*diagnosis/pathology/surgery ; Tomography, X-Ray Computed