Objective: To analyze the clinical features and prognosis of patients with cutaneous melanoma. Methods: The clinical data and follow-up data of 125 patients with cutaneous malignant melanoma (CMM) treated in the Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology between February 2008 and August 2019 were collected. Kaplan-Meier method and Log rank test were used for survival analysis, and Cox proportional risk regression model was used for impact factor analysis. Results: Among the 125 patients, 12 were stage Ⅰ, 62 were stage Ⅱ, 30 were stage Ⅲ, and 21 were stage Ⅳ; 76 were acral and 49 were non-acral. The median survival time was 44 months, and the 1-, 2-, and 5-year survival rates were 85.4%, 63.2% and 38.7%, respectively. Kaplan-Meier univariate survival analysis showed that Karnofsky performance status score, tumor stage, primary site, vascular infiltration, Ki-67, BRAF, lactate dehydrogenase (LDH), and surgical treatment were related to the prognosis of patients (P<0.05). The median overall survival (OS) time of patients receiving interferon treatment was 53 months, which was better than 40 months of patients not receiving interferon treatment, but the difference was not statistically significant (P=0.448). Among stage Ⅲ patients, the median OS time of patients receiving interferon therapy was 40 months, which was better than 17 months of patients not receiving interferon therapy (P=0.012). Among stage Ⅱ patients, the 1-, 2-, and 5-year survival rates of acral patients were 97.1%, 84.7%, and 65.8%, and the 1-, 2-, and 5-year survival rates of non-acral patients were 93.3%, 70.0% and 17.0%. The prognosis of patients with stage Ⅱ acral type was better than that of non-acral type (P=0.043). The median survival time of stage Ⅲ patients with acral type was 32 months, better than 17 months of non-acral type, but the difference was not statistical significance (P=0.164). The median survival time of acral type and non-acral type was 8 months and 11 months respectively (P=0.458). Cox multivariate analysis showed that tumor stage and preoperative LDH level were independent prognostic risk factors for cutaneous melanoma. Conclusions: Interferon treatment can improve the prognosis of patients with stage Ⅲ, and stage Ⅱ acral type patients have better prognosis than that of non-acral type patients. Tumor stage and preoperative LDH level were independent prognostic risk factors for cutaneous melanoma.
Humans ; Melanoma/surgery* ; Skin Neoplasms/pathology* ; Prognosis ; Interferons ; Retrospective Studies

Female ; Humans ; Melanoma/surgery* ; Neoplasms, Multiple Primary/pathology* ; Ovarian Neoplasms/pathology* ; Skin Neoplasms ; Teratoma/surgery*

Adolescent ; Carcinoma, Renal Cell ; metabolism ; pathology ; Desmin ; metabolism ; Diagnosis, Differential ; Humans ; Leg ; MART-1 Antigen ; metabolism ; Male ; Melanoma ; metabolism ; pathology ; Melanoma-Specific Antigens ; metabolism ; Perivascular Epithelioid Cell Neoplasms ; metabolism ; pathology ; surgery ; Sarcoma, Clear Cell ; metabolism ; pathology ; Skin Neoplasms ; metabolism ; pathology ; surgery

OBJECTIVETo investigate the clinicopathologic characteristics and differential diagnosis of the metastases to the breast from non-mammary malignancies.

METHODSTwenty-eight cases were collected from 2004 to 2012;microscopic pathologic examinations and immunohistochemistry (EnVision method) were performed.

RESULTS(1) All except one patients were female, ranging from 16 to 77 years old (average 45.8 years). Twenty-six (92.9%) patients initially presented with the primary site lesions; while the other two (7.1%) patients initially presented with breast lesions. The mean interval from primary diagnosis to detection of metastatic breast lesions was 32 months (0-228 months). Fifteen patients (53.6%) had other metastases detected simultaneously or preceded the breast lesions. (2) Macroscopically, all the tumors were relatively circumscribed, with a mean diameter of 4.0 cm (0.6-12.0 cm). The histological types of the corresponding primary tumors were as follows: eight (28.6%) cases from lung adenocarcinoma, five (17.8%) from high-grade ovarian serous carcinoma, three (10.7%) from gastric adenocarcinoma, two (7.1%) from rectal adenocarcinoma, one (3.6%) from pancreatic neuroendocrine carcinoma, one (3.6%) from prostatic carcinoma, four (14.3%) from melanoma, and four (14.3%) from mesenchymal malignant tumors (three rhabdomyosarcomas and one epithelioid malignant peripheral nerve sheath tumor, MPNST). (3) Histologically, the metastatic tumors showed the morphologic characteristics of the primary tumors. Lymph-vascular invasion was observed in 19 cases. Immunohistochemical features of metastatic tumors were consistent with the primary tumors. Molecular markers for breast such as GCDFP15 and mammaglobin were negative. Metastatic tumors from lung adenocarcinoma expressed TTF-1 (8/8). Ovarian serous carcinoma metastases were positive for PAX8 (5/5) and WT1 (4/5). Gastric adenocarcinoma metastases were positive for CDX2 (3/3) and villin (1/3). Rectal adenocarcinoma metastases were positive for CDX2 (2/2). Pancreatic neuroendocrine tumor metastasis was positive for Syn and CgA (both 1/1). Prostate carcinoma metastasis was positive for AR, PSA and P504S (all 1/1). Melanoma metastases were positive for HMB45 (2/3) and S-100 protein (3/3). Rhabdomyosarcoma metastases were positive for vimentin, desmin and myoD1 (all 3/3). MPNST metastasis was positive for S-100 protein (1/1). (4) Follow-up data was available in 17 patients, with median follow-up time 54 months. The median survival from diagnosis to breast metastasis was 24 months.Seven of 17 patients died.

CONCLUSIONSMetastases to the breast from non-mammary malignancies are rare and show pathologic features of primary tumors. It is usually presumed to be a primary breast carcinoma. Histopathologic features and clinical history in conjunction with the immunohistochemical results should be considered in differentiating a secondary mass from a primary breast carcinoma.

Adenocarcinoma ; secondary ; Adolescent ; Adult ; Aged ; Biomarkers, Tumor ; metabolism ; Breast Neoplasms ; pathology ; secondary ; surgery ; Breast Neoplasms, Male ; pathology ; secondary ; surgery ; Carcinoma, Neuroendocrine ; secondary ; Cystadenocarcinoma, Serous ; secondary ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Lung Neoplasms ; pathology ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Mastectomy ; Melanoma ; secondary ; Middle Aged ; Ovarian Neoplasms ; pathology ; Pancreatic Neoplasms ; pathology ; Rectal Neoplasms ; pathology ; Rhabdomyosarcoma ; secondary ; Stomach Neoplasms ; pathology ; Treatment Outcome ; Young Adult

OBJECTIVE: To investigate the clinopathological characteristics, differential diagnosis, therapy and prognosis of sinonasal mucosal malignant melanoma. METHOD: Clinopathological data of 18 cases which were diagnosed by pathology and immmunohistochemistry were analyzed retrospectively. All cases were proved by pathology and immmunohistochemistry. All cases were performed operations. 5 underwent single surgery. 4 underwent surgery plus adjuvant radiotherapy. 4 underwent surgery plus adjuvant radiotherapy chemotherapy. 5 underwent surgery plus adjuvant chemoradiation. RESULT: All cases were followed up for a period of 1 to 7 years after operation. Twelve patients died of tumor until the last follow-up, meanwhile 6 patients stayed alive. In Six cases recurrence occurred. In five casescervical lymph node metastasis occurred, of which 3 cases received neck dissection and 2 cases received chemotherapy and radiotherapy due to no surgical indications. In three cases distant metastasis oc- curred. CONCLUSION Sinonasal mucosal malignant melanoma is rare and highly heterogenous. Current diagnosis depends on clinical characteristics and immunohistochemical examination. It still should be differentially diagnosed from other tumors. CT and MRI image examination can provide some helpful information to understand the extent and nature of lesions. The treatment of nasal endoscopic or the surgery under endoscopy has become to be a safe, viable and reasonable alternative to open resection. Appropriate indication must be carefully selected for these lesions.
Chemotherapy, Adjuvant ; Endoscopy ; Humans ; Lymphatic Metastasis ; Melanoma ; drug therapy ; pathology ; surgery ; Mucous Membrane ; Neck Dissection ; Neoplasm Recurrence, Local ; Nose Neoplasms ; Paranasal Sinus Neoplasms ; drug therapy ; pathology ; surgery ; Prognosis ; Radiotherapy, Adjuvant ; Retrospective Studies

OBJECTIVETo study the clinicopathologic features and prognosis of plasmacytoid urothelial carcinoma (PUC) of the urinary bladder.

METHODSThe clinical and pathologic findings of 16 cases of PUC were retrospectively reviewed. Immunohistochemical study (MaxVision method) was carried out. The follow-up data were analyzed.

RESULTSThere were altogether 15 males and 1 female. The age of patients ranged from 40 years to 85 years (median = 64 years). Most patients (15/16) presented with hematuria. The tumor cells were small to medium in size and contained eccentric nuclei and moderate to abundant eosinophilic cytoplasm, assuming a plasmacytoid appearance. The architectural pattern varied from loosely cohesive sheets to cords, papillae, small nests or gland-like structures. Most tumors invaded into the lamina propria or muscularis propria. Twelve of the 16 cases had concurrent conventional urothelial carcinoma component. Immunohistochemical study showed that the tumor cells in all cases were strongly positive for AE1/AE3, epithelial membrane antigen, CK7 and CK18. CK20 and uroplakin III were also expressed in 9 cases. CEA, p53, CD138, p63 and E-cadherin were positive in 12, 13, 15, 11 and 10 cases, respectively. Ki-67 index ranged from 5% to 70% (mean = 30%). All tumors were negative for vimentin, LCA, kappa/lambda light chains, S-100 protein, HMB 45,Melan A, smooth muscle actin and desmin. Follow-up information was available in 13 patients. The duration of follow up ranged from 3 months to 10 years. Three patients died of distant metastasis at 3, 27 and 60 months after the operation, respectively. One patient was alive with disease at 25 months. One was alive at 43 months with a prior recurrence. Another 8 patients were alive and disease free at 7 to 120 months.

CONCLUSIONSPUC of the urinary bladder is a rare variant of high-grade urothelial carcinoma. Immunohistochemical study with positivity for CK7, CK20, p63 and uroplakin III and negative staining for vimentin and LCA may be helpful in the differential diagnosis. PUC is a malignant tumor with high invasiveness, high recurrence rate and poor prognosis. Radical cystectomy is considered as the first line treatment for PUC.

Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; metabolism ; Carcinoma, Signet Ring Cell ; metabolism ; pathology ; Carcinoma, Transitional Cell ; metabolism ; pathology ; surgery ; Cystectomy ; methods ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Keratin-20 ; metabolism ; Keratin-7 ; metabolism ; Male ; Melanoma ; metabolism ; pathology ; Membrane Proteins ; metabolism ; Middle Aged ; Neoplasm Recurrence, Local ; Plasma Cells ; pathology ; Plasmacytoma ; metabolism ; pathology ; Prognosis ; Retrospective Studies ; Syndecan-1 ; metabolism ; Urinary Bladder Neoplasms ; metabolism ; pathology ; surgery ; Uroplakin III ; metabolism

Actins ; metabolism ; Adult ; Diagnosis, Differential ; Endometrial Neoplasms ; metabolism ; pathology ; surgery ; Endometrial Stromal Tumors ; metabolism ; pathology ; surgery ; Female ; Humans ; Hysterectomy ; Leiomyoma, Epithelioid ; metabolism ; pathology ; Melanoma-Specific Antigens ; metabolism ; Perivascular Epithelioid Cell Neoplasms ; metabolism ; pathology ; surgery ; Receptors, Progesterone ; metabolism ; Sarcoma, Clear Cell ; metabolism ; pathology ; Uterine Neoplasms ; metabolism ; pathology ; surgery

Actins ; metabolism ; Angiomyoma ; metabolism ; pathology ; surgery ; Cranial Fossa, Middle ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Melanoma-Specific Antigens ; metabolism ; Middle Aged ; Perivascular Epithelioid Cell Neoplasms ; immunology ; S100 Proteins ; metabolism ; Skull Base Neoplasms ; metabolism ; pathology ; surgery

Meningeal melanocytoma is a rare benign tumor with relatively good prognosis. However, local aggressive behavior of meningeal melanocytoma has been reported, especially in cases of incomplete surgical resection. Malignant transformation was raised as possible cause by prior reports to explain this phenomenon. We present an unusual case of meningeal melanocytoma associated with histologically benign leptomeningeal spread and its subsequent aggressive clinical course, and describe its radiological findings.
Adult ; Humans ; Magnetic Resonance Imaging ; Male ; Melanoma/*pathology/surgery ; Meningeal Neoplasms/*pathology/surgery ; Neoplasm Invasiveness/pathology ; Prognosis

Abdominal Wall ; Adult ; Female ; Follow-Up Studies ; Humans ; Melanoma ; pathology ; surgery ; Pregnancy ; Pregnancy Complications, Neoplastic ; pathology ; surgery ; Skin Neoplasms ; pathology ; surgery