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Şendişçi Gök R, Tercanlı H. A ten-year literature review of oral malignant melanoma cases: A meta-analysis study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024:101922. [PMID: 38795910 DOI: 10.1016/j.jormas.2024.101922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 05/22/2024] [Indexed: 05/28/2024]
Abstract
AIM Oral malignant melanoma (OMM) is a rare and aggressive malignant tumour arising from the proliferation of melanocytes and accounts for only 0.5 % of all oral malignancies. It is invasive and tends to metastasise. The aim of this study is to determine the patient profile of OMM and to provide information about the clinical features and treatment plans of the disease. MATERIALS AND METHODS The Pubmed database was searched for OMM cases published as case reports in the last 10 years. The search was limited to English and open-access case reports. A total of 49 OMMs in 45 patients from 43 case reports were analyzed. In addition to the age, gender, smoking and alcohol consumption habits of the patients, data on the signs and symptoms of OMM, location of the lesion, imaging modalities used in diagnosis and treatment, lymph node involvement, presence of metastasis, survival time, and treatment modalities were recorded. RESULTS In OMM cases, 18 (40 %) of the patients were female, 27 (60 %) were male, and the mean age was 53.13 ± 16.09 years. The most common symptom was "swelling" (n = 23, 33.8 %) and the most common finding was "hyperpigmentation" (n = 40, 24.4 %). The most common site of OMM was the maxilla (n = 21, 46.7 %). According to the rate of use of imaging modalities in the cases, it was determined that "advanced imaging modalities" were mostly used (n = 24, 53.3 %). It was determined that 22.2 % (n = 10) of the patients died within the first 5 years. Combined treatment (n = 21, 46.5 %) were mostly applied to the patients. CONCLUSION OMM is more common in the maxilla, in males and in the fifth decade of life, and advanced imaging modalities are most commonly used to detect the disease. Because of its poor prognosis, knowing the patient profile and common clinical features of OMM will increase the clinical awareness of physicians.
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Affiliation(s)
- Rümeysa Şendişçi Gök
- Research asistant, Akdeniz University Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Antalya, Turkey.
| | - Hümeyra Tercanlı
- Associate professor, Akdeniz University Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Antalya, Turkey
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Heifetz-Li JJ, Smith MH, Roche A. Multifocal pigmented lesions in the maxilla. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:205-208. [PMID: 38171999 DOI: 10.1016/j.oooo.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 11/11/2023] [Accepted: 11/20/2023] [Indexed: 01/05/2024]
Affiliation(s)
| | | | - Ansley Roche
- Division of Otolaryngology-Head & Neck Surgery, Yale School of Medicine, New Haven, CT, USA
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Scherzad A, Stöth M, Meyer TJ, Haug L, Gehrke T, Schilling B, Meierjohann S, Scheich M, Hagen R, Gesierich A, Hackenberg S. Multimodal treatment and immune checkpoint inhibition in sinonasal mucosal melanoma: real-world data of a retrospective, single-center study. Eur Arch Otorhinolaryngol 2023; 280:4215-4223. [PMID: 37272953 PMCID: PMC10382337 DOI: 10.1007/s00405-023-08015-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/08/2023] [Indexed: 06/06/2023]
Abstract
PURPOSE Local failure and distant metastases occur frequently in sinonasal mucosal melanoma (SNMM). Response rates to chemotherapy are low and targetable mutations are rarely detected. However, there is increasing data indicating efficacy of immune checkpoint inhibition (ICI). The aim of this retrospective monocenter study was to assess the mutational landscape and to evaluate the outcome of surgical treatment and ICI in SNMM in a real-world setting. METHODS Thirty-eight SNMM patients being treated between 1999 and 2020 at our institution were retrospectively reviewed. Survival curves were generated according to Kaplan-Meier and compared by the log-rank test. RESULTS Local failure was seen in 60% of patients treated in a curative intent. Overall, 24% of all patients suffered from regional and 66% from distant metastases. Next generation sequencing revealed mutations of BRAF, NRAS and KRAS. One out of three patients treated with a primary ICI showed a complete response (CR) and two showed progressive disease. Eleven patients received ICI as a palliative treatment. CR could be observed in three patients and stable disease in one patient. In the whole study population, the 5-year overall survival rate (OS) was 26%. OS was better for patients who received ICI during the course of disease. CONCLUSIONS Recurrences and distant metastases are frequent in SNMM. Durable CR could be observed after primary and palliative ICI. Therefore, ICI in a palliative, adjuvant or even neoadjuvant setting might play a promising role in SNMM therapy while targetable mutations are rarely detected.
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Affiliation(s)
- Agmal Scherzad
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Manuel Stöth
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany.
| | - Till J Meyer
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Lukas Haug
- Institute of Pathology, University of Würzburg, 97080, Würzburg, Germany
| | - Thomas Gehrke
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Bastian Schilling
- Department of Dermatology, Venerology and Allergology, University Hospital Würzburg, 97080, Würzburg, Germany
| | - Svenja Meierjohann
- Institute of Pathology, University of Würzburg, 97080, Würzburg, Germany
- Comprehensive Cancer Center Mainfranken, University Hospital Würzburg, Würzburg, Germany
| | - Matthias Scheich
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Rudolf Hagen
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Anja Gesierich
- Department of Dermatology, Venerology and Allergology, University Hospital Würzburg, 97080, Würzburg, Germany
| | - Stephan Hackenberg
- Department of Otorhinolaryngology-Head and Neck Surgery, RWTH Aachen University Hospital, 52074, Aachen, Germany
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4
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Akay S, Pollard JH, Saad Eddin A, Alatoum A, Kandemirli S, Gholamrezanezhad A, Menda Y, Graham MM, Shariftabrizi A. PET/CT Imaging in Treatment Planning and Surveillance of Sinonasal Neoplasms. Cancers (Basel) 2023; 15:3759. [PMID: 37568575 PMCID: PMC10417627 DOI: 10.3390/cancers15153759] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
Sinonasal cancers are uncommon malignancies with a generally unfavorable prognosis, often presenting at an advanced stage. Their high rate of recurrence supports close imaging surveillance and the utilization of functional imaging techniques. Whole-body 18F-FDG PET/CT has very high sensitivity for the diagnosis of sinonasal malignancies and can also be used as a "metabolic biopsy" in the characterization of some of the more common subgroups of these tumors, though due to overlap in uptake, histological confirmation is still needed. For certain tumor types, radiotracers, such as 11C-choline, and radiolabeled somatostatin analogs, including 68Ga-DOTATATE/DOTATOC, have proven useful in treatment planning and surveillance. Although serial scans for posttreatment surveillance allow the detection of subclinical lesions, the optimal schedule and efficacy in terms of survival are yet to be determined. Pitfalls of 18F-FDG, such as post-surgical and post-radiotherapy crusting and inflammation, may cause false-positive hypermetabolism in the absence of relapse.
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Affiliation(s)
- Sinan Akay
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Janet H. Pollard
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Assim Saad Eddin
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Aiah Alatoum
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Sedat Kandemirli
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Ali Gholamrezanezhad
- Department of Radiology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA 90030, USA
| | - Yusuf Menda
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Michael M. Graham
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Ahmad Shariftabrizi
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
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6
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Grant‐Freemantle MC, Lane O'Neill B, Clover AJP. The effectiveness of radiotherapy in the treatment of head and neck mucosal melanoma: Systematic review and meta‐analysis. Head Neck 2020; 43:323-333. [DOI: 10.1002/hed.26470] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 08/30/2020] [Accepted: 09/04/2020] [Indexed: 12/23/2022] Open
Affiliation(s)
| | | | - Anthony James P. Clover
- School of Medicine University College Cork Cork Ireland
- Department of Plastic Surgery Cork University Hospital Cork Ireland
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7
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Romano A, Iaconetta G, Pansini A, Mascolo M, Cieri M, Abbate V, Salzano G, Dell'Aversana Orabona G, Califano L. Sinonasal mucosal melanoma extended to nose bridge: A one-time reconstruction treatment report. ORAL AND MAXILLOFACIAL SURGERY CASES 2018. [DOI: 10.1016/j.omsc.2017.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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8
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The Tumor Suppressor p53 in Mucosal Melanoma of the Head and Neck. Genes (Basel) 2017; 8:genes8120384. [PMID: 29236030 PMCID: PMC5748702 DOI: 10.3390/genes8120384] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 12/04/2017] [Accepted: 12/05/2017] [Indexed: 12/17/2022] Open
Abstract
Despite worldwide prevention programs, the incidence for cutaneous melanoma is continuously increasing. Mucosal melanoma (MM) represents a rare but highly aggressive phenotype of common melanoma with predilection in the sinonasal system. Far away from ultraviolet sun exposure, the molecular mechanisms underlying tumorigenesis and the highly aggressive clinical behavior are poorly understood. In many solid malignomas of the head and neck region, p53 tumor suppressor functions as oncogene due to p53 protein stabilizing mutation. Interestingly, the vast majority of MM demonstrates constitutively expressed p53 protein, with protein stabilizing mutations being rare. Abrogated activation of p53 target genes results in derogation of the apoptotic signal cascade and contributes to the strong resistance against chemotherapeutic agents activating p53 dependent apoptosis. The current review illustrates the role of p53 and its pathway in MM.
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Konuthula N, Khan MN, Parasher A, Del Signore A, Genden EM, Govindaraj S, Iloreta AM. The presentation and outcomes of mucosal melanoma in 695 patients. Int Forum Allergy Rhinol 2016; 7:99-105. [PMID: 27628440 DOI: 10.1002/alr.21831] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 07/02/2016] [Accepted: 07/08/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Most data on sinonasal mucosal melanoma come from small institutional studies, and therefore optimal treatment methods are not well understood. The purpose of this study was to analyze the association between treatment and survival in sinonasal mucosal melanoma. METHODS Six hundred ninety-five patients diagnosed with sinonasal mucosal melanoma between 2004 and 2010 were identified from the National Cancer Data Base. Treatment modalities and overall survival rates were determined. RESULTS The 5-year overall survival was 21.7%, with a mean survival of 38.4 ± 1.7 months. The majority of patients were treated with surgery alone (31.5%) or surgery with adjuvant radiotherapy (41.4%). There was no statistical difference between survival with surgery alone and surgery with adjuvant radiation therapy (25.1% vs 25.1%, p = 0.93). Between the surgery and surgery-with-adjuvant-therapy groups, there was no difference in the number of patients with positive margins (p = 0.54), regional lymph node metastases at diagnosis (p = 0.55), morbidity scores (p = 0.58), insurance status (p = 0.13), age > 60 years (p = 0.24), or treatment at academic centers (p = 0.12). CONCLUSIONS Based on this large review of patients with sinonasal mucosal melanoma, adjuvant radiation therapy may not provide a survival benefit as patients tended to do poorly regardless of adjuvant radiation status.
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Affiliation(s)
- Neeraja Konuthula
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Medical Center, New York, NY
| | - Mohemmed N Khan
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Medical Center, New York, NY
| | - Arjun Parasher
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Medical Center, New York, NY
| | - Anthony Del Signore
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Beth Israel, New York, NY
| | - Eric M Genden
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Medical Center, New York, NY
| | - Satish Govindaraj
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Medical Center, New York, NY
| | - Alfred M Iloreta
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Medical Center, New York, NY
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10
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Smith MH, Bhattacharyya I, Cohen DM, Islam NM, Fitzpatrick SG, Montague LJ, Damm DD, Fowler CB. Melanoma of the Oral Cavity: an Analysis of 46 New Cases with Emphasis on Clinical and Histopathologic Characteristics. Head Neck Pathol 2016; 10:298-305. [PMID: 26753505 PMCID: PMC4972758 DOI: 10.1007/s12105-016-0693-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 01/06/2016] [Indexed: 02/03/2023]
Abstract
Melanoma of the oral cavity is a rare malignancy that carries a poor prognosis. We identified 46 new cases of both primary and metastatic melanoma to the oral cavity. Following IRB approval, these cases were obtained from the Oral Pathology Biopsy Service archives of the UF College of Dentistry (1994-2014), the UK College of Dentistry (1997-2015), and the UM Medical Center (1988-2015). All slides were reviewed. The location, age, race, gender, clinical impression, duration of lesion, histopathologic diagnosis, and histopathologic features were recorded. Cases from the facial skin and those with an ambiguous diagnosis were excluded. Forty-six cases fulfilled the inclusion criteria with 32 primary cases, 11 known metastases, and 3 cases where metastasis could not be excluded. The primary cases included a total of 20 females and 12 males with an average age of 66.7 (range 27-95), and the majority (80 %) of the patients were Caucasian when race was known. Twenty-two of the 32 primary cases (68.8 %) were located in the maxillary mucosa, 5 in the mandibular mucosa or bone, and 5 in other locations. The clinicians' impressions varied from benign fibrous growths to high grade malignancies. The histopathology varied widely among the cases, however two cell types predominated (often in combination): epithelioid cells (50.0 %) and spindle cells (50.0 %). Only 53.1 % demonstrated melanin pigmentation. Oral melanoma remains one of the most diverse clinical and histopathologic diagnoses. Better understanding of this neoplasm may promote earlier diagnosis and may lead to improved outcomes.
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Affiliation(s)
- Molly Housley Smith
- Division of Oral and Maxillofacial Pathology, University of Florida College of Dentistry, 1395 Center Dr, Gainesville, FL, 32610-0414, USA.
| | - Indraneel Bhattacharyya
- Division of Oral and Maxillofacial Pathology, University of Florida College of Dentistry, 1395 Center Dr, Gainesville, FL, 32610-0414, USA
| | - Donald M Cohen
- Division of Oral and Maxillofacial Pathology, University of Florida College of Dentistry, 1395 Center Dr, Gainesville, FL, 32610-0414, USA
| | - Nadim M Islam
- Division of Oral and Maxillofacial Pathology, University of Florida College of Dentistry, 1395 Center Dr, Gainesville, FL, 32610-0414, USA
| | - Sarah G Fitzpatrick
- Division of Oral and Maxillofacial Pathology, University of Florida College of Dentistry, 1395 Center Dr, Gainesville, FL, 32610-0414, USA
| | - Lindsay J Montague
- Division of Oral and Maxillofacial Pathology, University of Mississippi Medical Center, School of Dentistry, 2500 North State Street, Jackson, MS, 39216, USA
| | - Douglas D Damm
- Division of Oral and Maxillofacial Pathology, University of Kentucky College of Dentistry, MN530, 800 Rose Street, Lexington, KY, 40536-0297, USA
| | - Craig B Fowler
- Division of Oral and Maxillofacial Pathology, University of Kentucky College of Dentistry, MN530, 800 Rose Street, Lexington, KY, 40536-0297, USA
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Grünmüller L, Thierauf J, Weissinger SE, Bergmann C, Bankfalvi A, Veit J, Hoffmann TK, Möller P, Lennerz JK. Biopanel identifies expression status of targetable proteins in sinonasal melanoma. Per Med 2016; 13:291-301. [PMID: 29749817 DOI: 10.2217/pme-2016-0023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Advanced stage at presentation, lack of BRAF mutations and overall rarity pose unique challenges to the therapy and trial design in sinonasal melanoma. METHODS Here, we assessed the expression status of 12 proteins in two independent cohorts of sinonasal melanoma (n = 20). RESULTS Each case showed expression of at least one protein (KIT, TP53, MYC, HER2, EGFR, MET, VEGFR, BRAF V600E and/or MDM2), whereas lack of ALK, FLI1 and PDGFRα expression underscores differences to cutaneous melanoma. Comparison of marker frequencies to a metareview of the literature indicates that MYC, HER2, EGFR and MET had not been previously assessed. CONCLUSION Expression of at least one potentially targetable protein per case illustrates proteome pathway profiling as one starting point for marker stratified trial design.
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Affiliation(s)
| | - Julia Thierauf
- Department of Otorhinolaryngology, Head & Neck Surgery, University Medical Center Ulm, Ulm, Germany
| | | | | | - Agnes Bankfalvi
- Department of Pathology, University Hospital Essen, Essen, Germany
| | - Johannes Veit
- Department of Otorhinolaryngology, Head & Neck Surgery, University Medical Center Ulm, Ulm, Germany
| | - Thomas K Hoffmann
- Department of Otorhinolaryngology, Head & Neck Surgery, University Medical Center Ulm, Ulm, Germany
| | - Peter Möller
- Institute of Pathology, Ulm University, Ulm, Germany
| | - Jochen K Lennerz
- Institute of Pathology, Ulm University, Ulm, Germany.,Department of Pathology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
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12
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Santos RSL, Andrade MF, Alves FDA, Kowalski LP, Perez DEDC. Metastases of Melanoma to Head and Neck Mucosa: A Report of Short Series. Clin Exp Otorhinolaryngol 2016; 9:80-4. [PMID: 26976032 PMCID: PMC4792238 DOI: 10.21053/ceo.2016.9.1.80] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 12/10/2014] [Accepted: 01/14/2015] [Indexed: 12/11/2022] Open
Abstract
Objectives Metastasis of melanoma to the head and neck mucosa is a very unusual condition. The aim of this study was to report four cases of patients with metastatic melanoma in the head and neck mucosa treated at a single institution. Methods Clinical data were obtained from the medical records. All cases were histologically reviewed to confirm the diagnosis, and immunohistochemical reactions were performed in the cases submitted to biopsy. Results All patients were males and the mean age was 40.5 years old. The sites of the metastatic tumors were gingival mucosa, floor of the mouth, oropharynx, and larynx. Two tumors appeared as submucosal nodules with normal color; one lesion was a blackish nodular lesion, and one was shown to be an ulcerated lesion. The size of tumors ranged from 2.0 to 4.0 cm. All patients had developed systemic disease at time of diagnosis of metastatic tumor in the head and neck mucosa. Survival rates ranged from 2 to 19 months after the diagnosis of the metastatic mucosal melanoma in the head and neck region. Conclusion Although rare, patients with melanoma must be closely and regularly followed up, with careful routine examination of head and neck, because metastatic tumors in this region seem to be part of a lethal widespread metastatic disease.
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Affiliation(s)
- Raphaela Silva Leandro Santos
- Department of Clinical and Preventive Dentistry, Oral Pathology Section, School of Dentistry, Federal University of Pernambuco, Recife, Brazil
| | - Marília Ferreira Andrade
- Department of Stomatology, A. C. Camargo Cancer Center, São Paulo, Brazil ; Department of Otorhinolaryngology-Head and Neck Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - Fábio de Abreu Alves
- Department of Stomatology, A. C. Camargo Cancer Center, São Paulo, Brazil ; Department of Otorhinolaryngology-Head and Neck Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - Luiz Paulo Kowalski
- Department of Stomatology, A. C. Camargo Cancer Center, São Paulo, Brazil ; Department of Otorhinolaryngology-Head and Neck Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - Danyel Elias da Cruz Perez
- Department of Clinical and Preventive Dentistry, Oral Pathology Section, School of Dentistry, Federal University of Pernambuco, Recife, Brazil
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Chatzistefanou I, Kolokythas A, Vahtsevanos K, Antoniades K. Primary mucosal melanoma of the oral cavity: current therapy and future directions. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:17-27. [PMID: 27039005 DOI: 10.1016/j.oooo.2016.01.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 01/04/2016] [Accepted: 01/05/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND Primary mucosal melanoma of the oral cavity is a highly aggressive malignancy of melanocytic origin. The aim of this study is to report a case series of oral mucosal melanomas (OMMs) and provide a review of the literature with regard to treatment guidelines for and prognosis of this pathologic entity. STUDY DESIGN We report three cases of OMMs treated in our institutions and the results of a literature review, in which the words "oral" and "mucosal melanoma" were used as the main keywords. RESULTS Surgical resection of the primary tumor with wide resection margins appears to be the recommended primary treatment modality with the aim to achieve tumor-free margins. Elective neck dissection and adjuvant radiotherapy have been advocated for locoregional control. Chemotherapy has not been shown to improve survival and is mainly used for palliative purposes. Immunotherapy and biochemotherapy seem to significantly improve survival and could open new therapeutic horizons. CONCLUSIONS The prognosis of OMMs remains poor despite treatment. Early diagnosis and aggressive surgical resection followed by adjuvant therapies could be the key to improving survival. Multicenter randomized clinical trials, which may be difficult to conduct because of the rarity to the lesion, would aid in the development of new strategies.
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Affiliation(s)
- Ioannis Chatzistefanou
- Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, "G. Papanikolaou" General Hospital, Thessaloniki, Greece
| | - Antonia Kolokythas
- Department of Oral and Maxillofacial Surgery, University of Rochester, Rochester, New York, USA.
| | - Konstantinos Vahtsevanos
- Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, "G. Papanikolaou" General Hospital, Thessaloniki, Greece
| | - Konstantinos Antoniades
- Department of Oral and Maxillofacial Surgery, University of Rochester, Rochester, New York, USA
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14
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Fritsche MK, Metzler V, Becker K, Plettenberg C, Heiser C, Hofauer B, Knopf A. Cisplatin fails to induce puma mediated apoptosis in mucosal melanomas. Oncotarget 2015; 6:9887-96. [PMID: 25831048 PMCID: PMC4496404 DOI: 10.18632/oncotarget.3195] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 01/23/2015] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES Mucosal melanomas (MM) are aggressive subtypes of common melanomas. It remains unclear whether limitations in their resectability or their distinctive molecular mechanisms are responsible for the aggressive phenotype. METHODS In total, 112 patients with cutaneous melanomas (CM) and 27 patients with MM were included. Clinical parameters were analysed using Chi square, Fisher exact and student's t-test. Survival rates were calculated by Kaplan-Meier. Analysis of p53, p21, Mdm2, Hipk2, Gadd45, Puma, Bax, Casp9 and Cdk1 via quantitative PCR and immunohistochemistry (IHC) was performed. TP53 induction after cisplatin treatment was analysed in 10 cell lines (melanocytes, four MM and five CM) using western blot (WB) and qPCR. RESULTS The overall/recurrence-free survival differed significantly between MM (40 months and 30 months) and CM (90 months and 107 months; p < 0.001). IHC and WB confirmed high p53 expression in all melanomas. Hipk2 and Gadd45 showed significantly higher expressions in CM (p < 0.005; p = 0.004). QPCR and WB of wild-type cell lines demonstrated no differences for p53, p21, Mdm2, Bax and Casp9. WB failed to detect Puma in MM, while Cdk1 regulation occurred exclusively in MM. CONCLUSIONS The aggressive phenotype of MM did not appear to be due to differential expressions of p53, p21, Mdm2, Bax or Casp9. A non-functional apoptosis in MM may have further clinical implications.
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Affiliation(s)
- Marie Kristin Fritsche
- Technische Universität München, Hals-Nasen-Ohrenklinik und Poliklinik, 81675 München, Germany
| | - Veronika Metzler
- Technische Universität München, Hals-Nasen-Ohrenklinik und Poliklinik, 81675 München, Germany
| | - Karen Becker
- Universität München, Institut für Allgemeine Pathologie und Pathologische Anatomie, 81675 München, Germany
| | - Christian Plettenberg
- Heinrich Heine Universität Düsseldorf, Hals-Nasen-Ohrenklinik, 40225 Düsseldorf, Germany
| | - Clemens Heiser
- Technische Universität München, Hals-Nasen-Ohrenklinik und Poliklinik, 81675 München, Germany
| | - Benedikt Hofauer
- Technische Universität München, Hals-Nasen-Ohrenklinik und Poliklinik, 81675 München, Germany
| | - Andreas Knopf
- Technische Universität München, Hals-Nasen-Ohrenklinik und Poliklinik, 81675 München, Germany
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Wu CF, Wu CS, Yu WW, Huang MY. Complete response of huge buccal malignant melanoma in an octogenarian patient to arterial chemotherapy. Head Neck 2014; 37:E134-8. [PMID: 25521097 DOI: 10.1002/hed.23941] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2014] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Primary oral mucosal melanoma is uncommon. However, it is an aggressive entity, and the absence of a standardized treatment protocol makes for an extremely poor prognosis. METHODS We described the clinical course and treatment by arterial chemotherapy of an 87-year-old patient with nonresectable huge buccal malignant melanoma. Continuous intra-arterial infusion of fluorouracil (50 mg/24 hours) and 1 intermittent weekly 10-mg shot of cisplatin were given. RESULTS The patient with oral melanoma presented with a roughly 6- × 4-cm exophytic mass that was noticed on the right buccal mucosa. The buccal tumor regressed dramatically until complete disappearance of the tumor mass was achieved at 2.5 months after intra-arterial chemotherapy was initiated. In total, 2880 mg of fluorouracil and 80 mg of cisplatin were administrated. The side effects of intra-arterial chemotherapy were mild and tolerable. CONCLUSION Our data demonstrate that intra-arterial chemotherapy could be an alternative treatment for nonresectable buccal malignant melanoma.
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Affiliation(s)
- Chih-Feng Wu
- Division of Surgical Oncology, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Surgery, Faculty of Medicine, College of Medicine, , Kaohsiung Medical University, Kaohsiung, Taiwan.,Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chieh-Shan Wu
- Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Wei-Wen Yu
- Department of Pathology and Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Ming-Yii Huang
- Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Radiation Oncology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Radiation Oncology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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16
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Wermker K, Brauckmann T, Klein M, Haßfeld S, Schulze HJ, Hallermann C. Prognostic value of S100/CD31 and S100/podoplanin double immunostaining in mucosal malignant melanoma of the head and neck. Head Neck 2014; 37:1368-74. [DOI: 10.1002/hed.23761] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 03/17/2014] [Accepted: 05/07/2014] [Indexed: 02/04/2023] Open
Affiliation(s)
- Kai Wermker
- Fachklinik Hornheide, Head and Neck Cancer Centre; Department of Cranio-Maxillofacial Surgery; Muenster Germany
| | - Till Brauckmann
- Fachklinik Hornheide, Head and Neck Cancer Centre; Department of Cranio-Maxillofacial Surgery; Muenster Germany
- University of Witten/Herdecke and Klinikum Dortmund; Department of Cranio-Maxillofacial Surgery; Dortmund Germany
| | - Martin Klein
- Fachklinik Hornheide, Head and Neck Cancer Centre; Department of Cranio-Maxillofacial Surgery; Muenster Germany
| | - Stefan Haßfeld
- University of Witten/Herdecke and Klinikum Dortmund; Department of Cranio-Maxillofacial Surgery; Dortmund Germany
| | - Hans-Joachim Schulze
- Fachklinik Hornheide, Skin Cancer Centre; Department of Dermatology and Dermato-Histo-Pathology; Muenster Germany
| | - Christian Hallermann
- Fachklinik Hornheide, Skin Cancer Centre; Department of Dermatology and Dermato-Histo-Pathology; Muenster Germany
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17
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Abstract
Sinonasal carcinomas are uncommon neoplasms accounting for approximately 3% to 5% of all upper respiratory tract malignancies. Sinonasal malignancies in most cases do not cause early symptoms and present in an advanced stage of disease. Exact staging necessitates a clinical and endoscopic examination with biopsy and imaging. Tumor resection using an open or endoscopic approach is usually considered the first treatment option. In general, sinonasal carcinomas are radiosensitive, so adjuvant or neoadjuvant radiation treatment may be indicated in advanced disease. Multidisciplinary surgical and medical oncologic approaches, including ablation and reconstruction, have enhanced the survival outcome over the past few decades.
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18
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Mun SJ, Jung HY, Frolova A, Park KD, Rhee CS. Malignant mucosal melanoma in the olfactory cleft of a 10-year-old child. Auris Nasus Larynx 2012; 40:235-8. [PMID: 22677526 DOI: 10.1016/j.anl.2012.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Revised: 04/27/2012] [Accepted: 05/05/2012] [Indexed: 11/28/2022]
Abstract
Mucosal malignant melanoma is a rare but aggressive neoplasm with high rates of recurrence and death. It is known that two-thirds of mucosal melanoma cases arise in the nasal cavity and paranasal sinuses in adults. However, there have been few studies until now on children with mucosal malignant melanoma and the related treatment. We report on a 10-year-old girl with mucosal malignant melanoma presented as a nasal polyp, which was removed via endoscopic sinus surgery and adjuvant chemotherapy without recurrence.
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Affiliation(s)
- Sue Jean Mun
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Republic of Korea
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19
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Palanivelu S, Jayanthi P, Rao UK, Joshua E, Ranganathan K. Rapidly enlarging mass following dental extraction. J Oral Maxillofac Pathol 2012; 15:223-7. [PMID: 22529586 PMCID: PMC3329701 DOI: 10.4103/0973-029x.84510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Oral melanoma (OM) is a rare, malignant neoplasm of melanocytic origin. It accounts for 0.2 - 8% of all melanomas. In contrast to its cutaneous counterpart, OM has poor prognosis, possibly due to late clinical diagnosis, nonexistence of standardized clinical or histopathological grading and anatomical limitation in complete excision of the lesion. For better understanding of the lesion, case reports are still considered to be the source of information. Here we present a case of oral primary melanoma occurring in an uncommon site, the mandibular gingiva, with review of related literature.
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Affiliation(s)
- Sivakumar Palanivelu
- Department of Oral and Maxillofacial Pathology, Karpaga Vinayaga Institute of Dental Sciences, Chengalpet, Kancheepuram, India
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20
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Mizoe JE, Hasegawa A, Jingu K, Takagi R, Bessyo H, Morikawa T, Tonoki M, Tsuji H, Kamada T, Tsujii H, Okamoto Y. Results of carbon ion radiotherapy for head and neck cancer. Radiother Oncol 2012; 103:32-7. [DOI: 10.1016/j.radonc.2011.12.013] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Revised: 11/11/2011] [Accepted: 12/28/2011] [Indexed: 02/03/2023]
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21
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Tas F, Keskin S, Karadeniz A, Dağoğlu N, Sen F, Kilic L, Yildiz I. Noncutaneous melanoma have distinct features from each other and cutaneous melanoma. Oncology 2012; 81:353-8. [PMID: 22248874 DOI: 10.1159/000334863] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Accepted: 11/01/2011] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Compared to the cutaneous melanoma, noncutaneous melanomas are relatively rare and have a distinct pattern of behavior. We performed this study to define the clinical characteristics and outcomes of patients with noncutaneous melanomas and emphasize how they differ from cutaneous melanomas. METHODS 216 patients who were diagnosed with noncutaneous melanoma were assessed and their medical records between 2000 and 2010 were retrieved from the cancer registry. 475 patients with cutaneous melanoma were used for comparison. RESULTS Of the 216 noncutaneous melanoma patients, 83 had mucosal melanoma, 101 had ocular melanoma and 32 had unknown primaries. For mucosal melanoma, the head and neck was the most common anatomic site (53%), followed by the gastrointestinal tract (37%), female genital (6%) and urinary tract (4%). The majority of the ocular melanomas (94%) originated in the uvea. 32 patients demonstrated a primary unknown disease with regional metastasis as the dominant behavior (72%). Age was found to be statistically significantly different among melanoma patients (p < 0.001). Younger patients had more cutaneous and unknown primary melanomas, whereas older patients had more ocular and mucosal melanoma. In subset analyses, we found significant differences between cutaneous and ocular (p = 0.038) or mucosal (p < 0.001) melanomas. The ratios of metastasis on admission were higher in patients with mucosal (27.7%) and unknown primary (28.1%) melanomas, and lower for ocular (3%) melanomas (p < 0.001). Patients with cutaneous melanoma had an intermediate (12%) ratio. Patients with ocular melanoma had better outcome than patients with other melanoma sites (p < 0.05). While overall survival for cutaneous melanoma was significantly negatively correlated with male gender (p < 0.001), advanced stages (p < 0.001) and old age (p = 0.005), stage IV disease was the only independent prognostic factor in patients with ocular melanoma (p = 0.006). No prognostic factor for outcome was found for either mucosal or unknown primary melanomas. CONCLUSION The clinical presentations and prognoses of different primary sites of melanoma are distinctive. Therefore, approaches to these melanomas should be different.
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Affiliation(s)
- Faruk Tas
- Institute of Oncology, University of Istanbul, Istanbul, Turkey.
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22
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Gal TJ, Silver N, Huang B. Demographics and treatment trends in sinonasal mucosal melanoma. Laryngoscope 2011; 121:2026-33. [PMID: 22024859 DOI: 10.1002/lary.21925] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Revised: 04/28/2011] [Accepted: 05/02/2011] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS To evaluate the population characteristics of mucosal melanoma of the nasal cavity and paranasal sinuses and determine the impact of the new staging classification. STUDY DESIGN Analysis of a national database. METHODS Patients were identified from the Surveillance, Epidemiology, and End Results tumor registry data with mucosal melanoma of the nasal cavity and paranasal sinuses between 2000 and 2007. Tumors were classified using the American Joint Committee on Cancer (AJCC) 6th edition site-specific staging as well as 7th edition staging for head and neck mucosal melanoma (HNMM). Incidence rates and descriptive statistics were calculated, and multivariate analysis was performed to examine the impact of demographic factors and staging on survival. RESULTS A total of 304 patients were identified. The incidence rate was 0.05 per 100,000. Fifty-six percent were female, 92% were >50 years old, and more than 90% were Caucasian; 81.6% of patients were treated with surgery, and 38.5% of patients received postoperative radiation. Overall, the 5-year survival rate was 24.2%. Significant differences in survival were observed for surgery with radiation (P = .005) and surgery alone (P = .04) compared with radiation alone. TNM staging using the AJCC 6th and 7th edition classification schemes yielded similar survival curves. However, the new classification for HNMM allows for better delineation of stage IV disease, revealing slightly improved survival for stage IVA disease. CONCLUSIONS HNMM is a rare disease with a poor prognosis. Surgery remains the treatment of choice, with some role for adjuvant therapy. The new staging classification for HNMM appears to more efficiently stage this disease. Demographics and therapeutic findings are discussed.
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Affiliation(s)
- Thomas J Gal
- Division of Otolaryngology-Head and Neck Surgery, University of Kentucky, Lexington, Kentucky 40536, USA.
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23
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Haerle SK, Soyka MB, Fischer DR, Murer K, Strobel K, Huber GF, Holzmann D. The value of 18F-FDG-PET/CT imaging for sinonasal malignant melanoma. Eur Arch Otorhinolaryngol 2011; 269:127-33. [PMID: 21713453 DOI: 10.1007/s00405-011-1664-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Accepted: 05/31/2011] [Indexed: 11/29/2022]
Abstract
The aim this study was to evaluate imaging findings using position emission tomography (PET) in combination with computed tomography (CT) and 18F-fluorodeoxyglucose ((18)F-FDG) in sinonasal malignant melanoma (SNMM) of the head and neck in a retrospective analysis of a consecutive cohort of patients. (18)F-FDG-PET/CT examinations were performed for initial staging and compared with CT or magnetic resonance tomography (MRI), and (18)F-FDG-PET alone. Medical records were reviewed retrospectively with regard to the location and the size of the tumor. Furthermore, locoregional and distant metastases with a consecutive change in therapy detected by (18)F-FDG-PET/CT were assessed. Ten patients suffering from sinonasal malignant melanoma were staged and followed by (18)F-FDG-PET/CT imaging. A total of 34 examinations were obtained. (18)F-FDG-PET/CT depicted all primary tumors adequately. Aside from one cerebral metastasis all regional and distant metastases were truly identified by using this method. In summary, if available, (18)F-FDG-PET/CT is a valuable imaging modality for staging and re-staging sinonasal malignant melanoma to evaluate expansion of the primary tumor, locoregional disease, and distant metastases.
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Affiliation(s)
- S K Haerle
- Department of Otolaryngology-Head and Neck Surgery, University Hospital Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland.
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Abstract
Noncutaneous melanoma is a rare entity for which there is still no agreement about management. The rarity of this disease has resulted in a lack of significant investigation and insufficient opportunity to evaluate the epidemiologic features, risk factors, and the most useful diagnostic and therapeutic approaches. Noncutaneous melanomas are characterized by poor prognosis, and the diagnosis is usually delayed because of their unusual locations and lack of physician awareness. This review focuses principally on ocular melanoma, the most frequent noncutaneous melanoma, for which each aspect of the disease is described. The potential utility of nuclear medicine procedures is also considered.
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Affiliation(s)
- Gaia Grassetto
- Department of Nuclear Medicine, PET/CT Centre, Santa Maria della Misericordia Hospital, Via Tre Martiri 140, 45100 Rovigo, Italy
| | - David Fuster
- Nuclear Medicine Department, Hospital Clínic of Barcelona, Villarroel 170, 08036 Barcelona, Spain
| | - Abass Alavi
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Domenico Rubello
- Department of Nuclear Medicine, PET/CT Centre, Santa Maria della Misericordia Hospital, Via Tre Martiri 140, 45100 Rovigo, Italy
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25
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Zimmermann I, Stuck BA, Sauter A, Hörmann K, Heiser C. [Primary malignant melanoma arising from the base of the tongue: a case report]. HNO 2010; 59:588-91. [PMID: 21181385 DOI: 10.1007/s00106-010-2233-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Primary mucosal melanoma is a biologically aggressive neoplasm, which is rarely located at the base of the tongue. The absence of early signs and symptoms, the lack of an evidence-based treatment, the early development of metastases and high rates of local recurrence contribute to the overall poor prognosis of these melanomas. This paper reports the case of a 66-year-old male presenting with local recurrence of a primary melanoma of the base of the tongue.
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Affiliation(s)
- I Zimmermann
- Universitäts-HNO-Klinik, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.
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26
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Yang X, Ren GX, Zhang CP, Zhou GY, Hu YJ, Yang WJ, Guo W, Li J, Zhong LP. Neck dissection and post-operative chemotherapy with dimethyl triazeno imidazole carboxamide and cisplatin protocol are useful for oral mucosal melanoma. BMC Cancer 2010; 10:623. [PMID: 21070637 PMCID: PMC2993680 DOI: 10.1186/1471-2407-10-623] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Accepted: 11/11/2010] [Indexed: 02/03/2023] Open
Abstract
Background Oral mucosal melanoma (OMM) is a clinically rare disease with poor prognosis. Various treatment methods have been investigated with the aim of improving the prognosis. This study aimed to analyze the data of a single institution in the management of OMM. Methods A total of 78 consecutive OMM patients were included in this retrospective study. The intraoral lesion was treated either by cryotherapy, surgery or both; the neck was treated by neck dissection or observation; post-operative chemotherapy with dimethyl triazeno imidazole carboxamide and cisplatin was performed in some patients. The Kaplan-Meier method was used for statistical analysis. Results Among the 78 patients, there were 50 males and 28 females with an average age of 53.8 years (ranging from 27 to 85 years). The most common sites of OMM were the hard palate and gingiva. The main cause of death in OMM was distant metastasis. No significant difference was found between the intraoral/cervical lesion recurrence/post-operative distant metastasis and the intraoral lesion site/biopsy method/treatment method. The metastasis rate of cervical lymph node was high in the OMM patients, even in the patients with clinically negative necks. Cervical lesion recurrence was correlated with N stage and intraoral lesion recurrence. The survival period was longer in the patients with T3 staging, clinical stage III disease, with post-operative chemotherapy and without post-operative distant metastasis when compared to those patients with T4a staging, clinical stage IV disease, without post-operative chemotherapy and with post-operative distant metastasis. Conclusions Radical surgery including wide intraoral resection and neck dissection is recommended for OMM patients. Post-operative chemotherapy may also be beneficial for both primary and recurrent OMM patients.
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Affiliation(s)
- Xi Yang
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, School of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, China
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27
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Cekin E, Cincik H, Yilmaz I, Gungor A. Primary malignant melanoma of the trachea: case report. EAR, NOSE & THROAT JOURNAL 2010; 89:E18-20. [PMID: 20628973 DOI: 10.1177/014556131008900703] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
A 22-year-old man was admitted with complaints of dyspnea and hoarseness. Laryngoscopy and computed tomography of the neck revealed a 1.5 x 2-cm solid mass obstructing the trachea. The black, pedunculated mass was completely removed through a tracheal incision, and a paratracheal lymph node dissection was performed. Histopathologic examination revealed nodular-type mucosal malignant melanoma. Cranial and thoracic computed tomography, abdominal ultrasonography, and histopathologic examination of the paratracheal lymph nodes showed no metastases. No recurrence has been noted in more than 3 years of follow-up.
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Affiliation(s)
- Engin Cekin
- Department of ENT, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey.
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28
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Mücke T, Hölzle F, Kesting MR, Loeffelbein DJ, Robitzky LK, Hohlweg-Majert B, Tannapfel A, Wolff KD. Tumor Size and Depth in Primary Malignant Melanoma in the Oral Cavity Influences Survival. J Oral Maxillofac Surg 2009; 67:1409-15. [DOI: 10.1016/j.joms.2008.12.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2008] [Revised: 10/09/2008] [Accepted: 12/07/2008] [Indexed: 12/21/2022]
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29
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Bartell HL, Bedikian AY, Papadopoulos NE, Dett TK, Ballo MT, Myers JN, Hwu P, Kim KB. Biochemotherapy in patients with advanced head and neck mucosal melanoma. Head Neck 2009; 30:1592-8. [PMID: 18798304 DOI: 10.1002/hed.20910] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND No systemic therapy regimen has been recognized as effective for metastatic mucosal melanoma of the head and neck. We retrospectively analyzed the effectiveness of biochemotherapy in patients with advanced head and neck mucosal melanoma. METHODS We evaluated the medical records of 15 patients at our institution who had received various biochemotherapy regimens for advanced head and neck mucosal melanoma. RESULTS After a median follow-up duration of 13 months, 3 patients (20%) had partial response, and 4 patients (27%) had complete response. The median time to disease progression for all 15 patients was 10 months. The median overall survival duration for all patients was 22 months. CONCLUSIONS Although this was a small study, our results, especially the high complete response and overall response rates, indicate that biochemotherapy for advanced head and neck mucosal melanoma should be considered as a systemic treatment option for patients with this aggressive malignancy.
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Affiliation(s)
- Holly L Bartell
- The University of Texas Medical School at Houston, Houston, Texas, USA
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30
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Marunick M, Oh WS. Prosthodontic treatment considerations for patients with oral sinonasal mucosal malignant melanoma: A clinical report. J Prosthet Dent 2009; 101:85-91. [DOI: 10.1016/s0022-3913(09)00012-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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31
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Díaz Molina JP, Rodrigo Tapia JP, Llorente Pendas JL, Suárez Nieto C. Melanomas mucosos rinosinusales. Revisión de 17 casos. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2008. [DOI: 10.1016/s0001-6519(08)75518-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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32
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Meleti M, Vescovi P, Mooi WJ, van der Waal I. Pigmented lesions of the oral mucosa and perioral tissues: a flow-chart for the diagnosis and some recommendations for the management. ACTA ACUST UNITED AC 2008; 105:606-16. [PMID: 18206403 DOI: 10.1016/j.tripleo.2007.07.047] [Citation(s) in RCA: 123] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2007] [Revised: 05/13/2007] [Accepted: 07/30/2007] [Indexed: 12/15/2022]
Abstract
The term "pigmentation of the oral mucosa" is applied to a wide range of lesions or conditions featuring a change of color of oral tissues. Lesions not associated with an accumulation of pigment (e.g., Fordyce spots) are usually not classified as pigmented lesions. Two groups of pigmented lesions of the oral mucosa are recognized: 1) melanin-associated lesions, including racial pigmentations, melanotic macules, melanocytic nevi, and malignant melanoma; and 2) nonmelanin-associated lesions (e.g., blood-related pigmentations, metallic pigmentations). This paper presents a clinicopathologic review of the recent literature with emphasis on the main diagnostic features, including the use of immunohistochemical markers. A flow-chart is added that may help the clinician in the diagnosis and management of these lesions.
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Affiliation(s)
- Marco Meleti
- Unit of Oral Pathology and Medicine, Section of Odontostomatology, Department of ENT, Dental, Ophthalmological, and Cervicofacial Sciences, University of Parma, Parma, Italy
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33
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Díaz Molina JP, Rodrigo Tapia JP, Llorente Pendas JL, Suárez Nieto C. Sinonasal Mucosal Melanomas. Review of 17 Cases. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2008. [DOI: 10.1016/s2173-5735(08)70280-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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34
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Abstract
Melanomas of the mucous membranes of airway tract constitute around 1% of the total melanomas of head and neck. The most common site of the tumor are the nasal and paranasal sinuses but melanomas of the oral cavity are described too. The location of malignant melanoma in the eustachian tube is very rare. We found five cases of this disease in the literature. In our article we present a 53-year-old woman with progressive left aural fullness and hearing impairment for two months. Clinical examination found left middle ear effusion. The nasopharyngoscopy revealed a bluish red, friable and granulomatous tumor occupying the whole pharyngeal orifice of the left auditory tube. The biopsy speciment was taken which established the diagnosis. Because of localization and spread of the melanoma we had a low opinion of surgical treatment and radiotherapy was recommended. The patient was under constant laryngologic and oncological observation. We did not notice the local recurrence of melanoma. She died two years after making the diagnosis because of the neoplasm dissemination.
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35
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Meleti M, Leemans CR, Mooi WJ, van der Waal I. Oral Malignant Melanoma: The Amsterdam Experience. J Oral Maxillofac Surg 2007; 65:2181-6. [DOI: 10.1016/j.joms.2006.10.044] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2006] [Revised: 10/15/2006] [Accepted: 10/19/2006] [Indexed: 12/26/2022]
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36
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Boulaadas M, Benazzou S, Mourtada F, Sefiani S, Nazih N, Essakalli L, Kzadri M. Primary Oral Malignant Melanoma. J Craniofac Surg 2007; 18:1059-61. [PMID: 17912082 DOI: 10.1097/scs.0b013e3180f6120e] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Malignant melanoma of the oral cavity is a rare neoplasm. It is well known for his poor prognosis and the need for an evidence-based treatment. Therapy is commonly based on surgical excision of the primary tumour, supplemented by adjuvant therapy. In this paper two new cases of primary oral melanoma are reported with a review of the literature.
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Affiliation(s)
- Malik Boulaadas
- Department of Oral and Maxillofacial Surgery, Avicenne Hospital, Rabat, Morocco
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37
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Sanderson AR, Gaylis B. Malignant Melanoma of the Sinonasal Mucosa: Two Case Reports and a Review. EAR, NOSE & THROAT JOURNAL 2007. [DOI: 10.1177/014556130708600514] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Malignant melanoma of the sinonasal cavity is an uncommon disease, and therefore a limited amount of data exists regarding its optimal treatment. The course of the disease is highly variable. Individual survival is also highly variable, but the overall prognosis is poor, probably because patients generally present at a late stage and because the disease has a proclivity for distant dissemination. We describe 2 recent cases of primary malignant melanoma of the sinonasal mucosa, and we review the literature.
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Affiliation(s)
| | - Brendan Gaylis
- Department of Head and Neck Surgery, Kaiser Permanente, San Diego
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Stárek I, Koranda P, Benes P. Sentinel lymph node biopsy: A new perspective in head and neck mucosal melanoma? Melanoma Res 2007; 16:423-7. [PMID: 17013091 DOI: 10.1097/01.cmr.0000222603.57932.b6] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Sentinel lymph node biopsy in patients with head and neck mucosal melanomas has not been performed so far. Therefore, this method as a staging tool was tested in a pilot study. In two consecutive patients, a lymphoscintigraphy, elective neck dissection with radio-guided sentinel lymph node identification, and resection of the primary were performed. The histopathological status of the sentinel lymph node was compared with the lymphadenectomy specimen and with the clinical course. Patient no. 1, in whom both the sentinel lymph node and the lymphadenectomy specimen were found to be free of tumour, is well and with no evidence of disease, the follow-up interval being 19 months. Patient no. 2, with the sentinel lymph node and remaining lymphatic basin being positive and negative, respectively, developed hematogenous dissemination 3 months after the primary treatment, and he was started on palliative chemotherapy. In mucosal melanoma, the prognostic significance of clinical nodal status is controversial, resulting in the lack of an official, applicable TNM classification and also of therapeutic guidelines. The presence of microscopic metastatic focus in the sentinel lymph node was associated with an early hematogenous dissemination. Therefore, sentinel lymph node biopsy, which represents a potentially efficient staging tool, warrants further investigation.
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Affiliation(s)
- Ivo Stárek
- ORL Clinic, Faculty Hospital Olomouc, Olomouc, Czech Republic.
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Meleti M, Leemans CR, Mooi WJ, Vescovi P, van der Waal I. Oral malignant melanoma: A review of the literature. Oral Oncol 2007; 43:116-21. [PMID: 16931116 DOI: 10.1016/j.oraloncology.2006.04.001] [Citation(s) in RCA: 109] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2006] [Revised: 04/03/2006] [Accepted: 04/04/2006] [Indexed: 12/11/2022]
Abstract
Primary oral malignant melanoma (OMM) is a rare neoplasm, accounting for 0.5% of all oral malignancies. The etiology is unknown; tobacco use and chronic irritation may play some role. Clinically, OMM may mimick other pigmented lesions. A biopsy is required in order to establish the diagnosis. The reported risk of malignant cells spreading during invasive procedures and factors such as size of the lesion or anatomical limitations, may influence the diagnostic surgical procedure. Therapy of OMM is commonly based on surgical excision of the primary tumour, supplemented by radiotherapy, with chemotherapy and immunotherapy serving as adjuncts. Prognosis is poor, with a 5-year survival rate of approximately 15%.
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Affiliation(s)
- Marco Meleti
- Unit of Oral Pathology and Medicine, Section of Odontostomatology, Department of ENT/Dental/Ophthalmological and Cervico-Facial Sciences, University of Parma, Italy
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Spugnini EP, Dragonetti E, Vincenzi B, Onori N, Citro G, Baldi A. Pulse-mediated chemotherapy enhances local control and survival in a spontaneous canine model of primary mucosal melanoma. Melanoma Res 2006; 16:23-7. [PMID: 16432452 DOI: 10.1097/01.cmr.0000195702.73192.a0] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Mucosal melanomas account for 1% of all malignant melanomas in humans. Treatment options include surgery, chemotherapy, immunotherapy and radiation therapy; however, local recurrence and distant dissemination are still frequent. We treated locally aggressive spontaneous canine oral melanomas that, because of their advanced stage, were not treatable with conventional strategies. A cohort of 10 dogs with oral melanoma was enrolled over a 4-year period. The dogs received two sessions of local bleomycin, followed by the application of trains of biphasic pulses. The treatment was well tolerated and resulted in an overall response rate of 80% with 50% long-term control. Of interest, only one of the dogs died of metastatic disease, and four of the long-term survivors showed a vitiligo-like discoloration at the site of treatment, potentially suggesting a recruitment of the immune system by the therapy. Further studies are needed to characterize this approach and to determine its suitability for head and neck mucosal melanoma.
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Andreadis D, Poulopoulos A, Nomikos A, Epivatianos A, Barbatis C. Diagnosis of metastatic malignant melanoma in parotid gland. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.ooe.2005.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kawahara K, Lee YJ, Nagatsuka H, Rui K, Auerkari EI, Floresca MCGZ, Kishikawa H, Nagai N. A Study of Eight Oral Malignant Melanoma in Adults by WESTOP (Western Society of Teachers of Oral Pathology, 1995). J HARD TISSUE BIOL 2005. [DOI: 10.2485/jhtb.14.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Cohen Y, Rosenbaum E, Begum S, Goldenberg D, Esche C, Lavie O, Sidransky D, Westra WH. Exon 15 BRAF mutations are uncommon in melanomas arising in nonsun-exposed sites. Clin Cancer Res 2004; 10:3444-7. [PMID: 15161700 DOI: 10.1158/1078-0432.ccr-03-0562] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE An activating point mutation of the BRAF oncogene has been identified in a high proportion of cutaneous nevi and cutaneous melanomas, but its frequency in melanomas arising from the mucosa of head and neck is unknown. EXPERIMENTAL DESIGN We tested 17 malignant mucosal melanomas of the head and neck for the thymine (T)-->adenine (A) missense mutation at nucleotide 1796 in the BRAF gene using direct sequencing and a newly developed assay that uses a novel primer extension method (Mutector assay). We also tested 21 cutaneous melanomas, including 13 arising from sun-exposed sites and 8 from a nonsun-exposed site, the vulvar skin. RESULTS The 1796T-->A mutation was detected in only 1 (6%) of the sinonasal melanomas. As for cutaneous melanomas, a BRAF mutation was detected in 8 (62%) of the tumors arising in sun-exposed sites but in none (0%) of vulvar melanomas. CONCLUSIONS In contrast to cutaneous melanomas arising in sun-exposed sites, mucosal melanomas of the head and neck do not frequently harbor an activating mutation of BRAF. This finding additionally supports the view that the various subtypes of melanoma are not equivalent and that distinct genetic alterations may underlie well recognized differences in risk factors and behavioral patterns. Accordingly, patients with melanomas should not be collectively regarded as a uniform group as new strategies are developed that target specific genetic alterations.
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Affiliation(s)
- Yoram Cohen
- Department of Otolaryngology, Head and Neck Surgery, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21231, USA
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