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Nurla LA, Aşchie M, Cozaru GC, Boșoteanu M. Multiple Primary Melanoma Associated with CDKN2A Mutation-Case Report and Review of the Literature. Medicina (Kaunas) 2024; 60:763. [PMID: 38792946 DOI: 10.3390/medicina60050763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/22/2024] [Accepted: 05/03/2024] [Indexed: 05/26/2024]
Abstract
The CDKN2A gene remains understudied in melanoma compared to BRAF alterations. Inactivation of this tumor suppressor gene through homozygous deletions in the 9p21 chromosomal region leads to cellular proliferation and disrupts pro-apoptotic pathways. Genetic changes in CDKN2A are linked to multiple primary melanomas (MPM), with patients diagnosed with melanoma facing an elevated risk of developing additional primaries. We present the rare case of a 72-year-old Caucasian woman with nine metastasizing melanomas across diverse anatomical sites, posing a diagnostic challenge. Initial diagnosis in 2022 revealed ulcerated superficial spreading melanomas, progressing to intradermal and papillary dermal populations with neurotropism and angiotropism by early 2023. Lymph node metastases were identified, classifying the condition as pT3b N3b. Subsequent assessments in April 2023 revealed clinically suspicious melanocytic lesions diagnosed as intradermal and traumatized junctional nevi. In late 2023, cutaneous pigmented lesions and subcutaneous metastases were confirmed as nodular nevoid low-CSD multiple melanomas. Fluorescence in situ hybridization testing revealed homozygous CDKN2A deletion, necessitating close multidisciplinary collaboration for an optimized care plan for effective monitoring and intervention in this intricate clinical scenario. In summary, this case report highlights the diagnostic challenges of MPM in a single patient. Stressing the importance of immuno-histochemistry and CDKN2A genetic testing, our findings underscore the crucial role of these tools in accurately distinguishing malignant melanocytic proliferations from nevi and characterizing MPM cases.
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Affiliation(s)
- Luana-Andreea Nurla
- Department of Dermatovenerology, "Elias" Emergency University Hospital, 011461 Bucharest, Romania
- Institute of Doctoral Studies, Doctoral School of Medicine, "Ovidius" University of Constanţa, 90052 Constanţa, Romania
| | - Mariana Aşchie
- Clinical Service of Pathology, "Sf. Apostol Andrei" Emergency County Hospital, 011461 Constanţa, Romania
- Department of Pathology, Faculty of Medicine, "Ovidius" University of Constanţa, 90052 Constanţa, Romania
- Department VIII-Medical Sciences, Academy of Romanian Scientists, 050044 Bucharest, Romania
| | - Georgeta Camelia Cozaru
- Clinical Service of Pathology, "Sf. Apostol Andrei" Emergency County Hospital, 011461 Constanţa, Romania
- Center for Research and Development of The Morphological and Genetic Studies of Malignant Pathology (CEDMOG), 900591 Constanţa, Romania
| | - Mădălina Boșoteanu
- Clinical Service of Pathology, "Sf. Apostol Andrei" Emergency County Hospital, 011461 Constanţa, Romania
- Department of Pathology, Faculty of Medicine, "Ovidius" University of Constanţa, 90052 Constanţa, Romania
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Smith J, Cust AE, Lo SN. Risk factors for subsequent primary melanoma in patients with previous melanoma: a systematic review and meta-analysis. Br J Dermatol 2024; 190:174-183. [PMID: 37562043 DOI: 10.1093/bjd/ljad275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/27/2023] [Accepted: 07/29/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Compared with the general population, people with a previous melanoma are at increased risk of developing another primary melanoma. Understanding the risk factors associated with multiple primary melanomas can inform patient education and tailored surveillance. OBJECTIVES To examine the risk factors for subsequent primary melanoma in people with a previous melanoma, by conducting a systematic review and meta-analysis of the available data. METHODS A systematic literature search was conducted in CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Embase and MEDLINE. Studies that reported a risk estimate or raw frequencies and conducted between 1982 and August 2022 were included. Adjusted risk estimates were prioritized over univariable risk estimates. PRISMA reporting guidelines were followed. Random effects meta-analysis was conducted to derive pooled estimates. Quality assessment was conducted by two researchers using the Newcastle-Ottawa scale. GRADE was used to rate the certainty and quality of the evidence. RESULTS Data from 27 studies involving 413 181 participants were pooled and analysed. Risk factors assessed included age and sex, environmental, lifestyle, phenotypic, genetic and histopathological factors, and there was wide variation in how they were categorized and analysed. Independent risk factors identified from pooled analyses included male sex [hazard ratio (HR) 1.46, 95% confidence interval (CI) 1.40-1.53], increasing age per 10 years (HR 1.19, 95% CI 1.14-1.24), light skin colour (HR 1.44, 95% CI 1.23-1.70), family history [odds ratio (OR) 1.79, 95% CI 1.25-2.56], CDKN2A mutation (OR 5.29, 95% CI 2.70-10.37), a high or moderate naevus count [OR 2.63 (95% CI 1.61-4.30) and OR 1.64 (95% CI 1.07-2.51), respectively], one or more atypical naevi (OR 3.01, 95% CI 1.52-5.97), first lesions occurring on the head or neck, lentigo maligna subtype (HR 1.16, 95% CI 1.15-1.17), other subtype (HR 1.14, 95% CI 1.03-1.27) and inadequate sun protection (HR 1.85, 95% CI 0.98-3.50). Based on the GRADE criteria, there was high to very low confidence in the pooled effect estimates. CONCLUSIONS This meta-analysis identified several consistent, independent risk factors for the development of subsequent primary melanoma. These findings will help stratify the risk of subsequent melanoma, tailor skin-check schedules and inform patient education.
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Affiliation(s)
- Juliet Smith
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
- Melanoma Institute Australia
- Sydney School of Public Health
| | - Anne E Cust
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
- Melanoma Institute Australia
- Sydney School of Public Health
| | - Serigne N Lo
- Melanoma Institute Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Johnston L, Starkey S, Mukovozov I, Robertson L, Petrella T, Alhusayen R. Surveillance After a Previous Cutaneous Melanoma Diagnosis: A Scoping Review of Melanoma Follow-Up Guidelines. J Cutan Med Surg 2023; 27:516-525. [PMID: 37489919 PMCID: PMC10617001 DOI: 10.1177/12034754231188434] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/30/2023] [Accepted: 06/20/2023] [Indexed: 07/26/2023]
Abstract
INTRODUCTION Cutaneous melanoma accounts for more than 70% of all skin cancer deaths. Follow-up surveillance is an integral part of melanoma patient care, to facilitate early detection of recurrences and subsequent primary melanomas. The purpose of this scoping review is to provide an overview of recently published melanoma surveillance guidelines from regional and national melanoma working groups. METHODS A systematic search for relevant studies in MEDLINE and Embase was conducted in September 2022 and was limited to publications from 2010 or later. RESULTS A total of 1047 articles were retrieved, and after abstract and full text review, 26 articles from 19 different organizations met inclusion criteria. Life-long annual skin surveillance with a physician was recommended by 53% (9/17) of guidelines. Routine laboratory investigations were recommended by 7/19 guidelines. Regional lymph node ultrasound was recommended by 9/16 guidelines, most often in stage IB or higher, and was optional in 7/16 for patients who met specific criteria. Surveillance with PET-CT or CT and MRI was recommended by 15 and 11 guidelines, respectively, most commonly in stage IIC or higher, with a variable frequency and total duration. Five out of 9 guidelines indicated a preference for skin surveillance to be completed with a dermatologist. CONCLUSION Guidelines were highly variable for many aspects of melanoma surveillance, which may be partly attributed to regional differences in healthcare workforce distribution and availability of imaging technologies. Further high-level studies are recommended to provide more evidence on the most effective clinical and imaging follow-up surveillance protocols.
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Affiliation(s)
- Leah Johnston
- Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Samantha Starkey
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Ilya Mukovozov
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - Lynne Robertson
- Division of Dermatology, University of Calgary, Calgary, AB, Canada
| | - Teresa Petrella
- Department of Medical Oncology, Odette Cancer Centre, Toronto, Canada
| | - Raed Alhusayen
- Sunnybrook Research Institute, Division of Dermatology, University of Toronto, Toronto, Canada
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Antoñanzas J, Morello-Vicente A, Garnacho-Saucedo GM, Redondo P, Aguado-Gil L, Salido-Vallejo R. Risk of Second Primary Malignancies in Melanoma Survivors: A Population-Based Study. Cancers (Basel) 2023; 15:cancers15113056. [PMID: 37297018 DOI: 10.3390/cancers15113056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/01/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023] Open
Abstract
(1) Introduction: The association between melanoma (MM) and the occurrence of second primary neoplasms (SPNs) has been extensively studied, with reported incidence rates ranging from 1.5% to 20%. This study aims to evaluate the occurrence of SPNs in patients with a history of primary MM and to describe the factors that make the risk higher in our population. (2) Material and Methods: We conducted a prospective cohort study and calculated the incidence rates and relative risks (RR) for the development of different SPNs in 529 MM survivors from 1 January 2005 to 1 August 2021. Survival and mortality rates were obtained, and the Cox proportional hazards model was used to determine the demographic and MM-related factors that influence the overall risk. (3) Results: Among the 529 patients included, 89 were diagnosed with SPNs (29 prior to MM diagnosis, 11 synchronous, and 49 after MM), resulting in 62 skin tumors and 37 solid organ tumors. The estimated probability of developing SPNs after MM diagnosis was 4.1% at 1 year, 11% at 5 years, and 19% at 10 years. Older age, primary MM location on the face or neck, and histologic subtype of lentigo maligna mm were significantly associated with a higher risk of SPNs. (4) Conclusions: In our population, the risk of developing SPNs was higher in patients with primary MM located on the face and neck and with the histological subtype of lentigo maligna-MM. Age also independently influences the risk. Understanding these hazard factors can aid in the development of MM guidelines with specific follow-up recommendations for individuals with the highest risk.
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Affiliation(s)
- Javier Antoñanzas
- Dermatology Department, University Clinic of Navarra, 31008 Pamplona, Spain
| | | | | | - Pedro Redondo
- Dermatology Department, University Clinic of Navarra, 31008 Pamplona, Spain
| | - Leyre Aguado-Gil
- Dermatology Department, University Clinic of Navarra, 31008 Pamplona, Spain
| | - Rafael Salido-Vallejo
- Dermatology Department, University Clinic of Navarra, 31008 Pamplona, Spain
- Dermatology Department, Reina Sofía University Hospital, 14004 Cordoba, Spain
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Pastor-Tomás N, Bañuls J, Nagore E. Clinical Relevance of Cherry Angiomas. Actas Dermosifiliogr 2023; 114:240-246. [PMID: 36370831 DOI: 10.1016/j.ad.2022.10.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/22/2022] [Accepted: 10/24/2022] [Indexed: 11/10/2022] Open
Abstract
Cherry angiomas are the most common vascular tumors of the skin. They are particularly prevalent in the general population and become more common with age. Although an association with cancer was suggested at the end of the 19th century, when these tumors were first described, it could not be demonstrated. For many decades, therefore, cherry angiomas were considered to have no clinical relevance other than their association with age. A number of studies in recent years, however, have shown a link between cherry angiomas and exposure to various toxic substances and medications, benign and malignant diseases, and immunosuppression, rekindling interest in these lesions and providing clues for a better understanding of their etiology, pathophysiology, and clinical relevance.
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Affiliation(s)
- N Pastor-Tomás
- Servicio de Dermatología, Hospital General Universitario de Elda, Elda, Alicante,Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, València, España.
| | - J Bañuls
- Servicio de Dermatología, Hospital General Universitario de Alicante-ISABIAL, Alicante, Departamento de Medicina Clínica, Universidad Miguel Hernández, Sant Joan d'Alacant, Alicante, España
| | - E Nagore
- Servicio de Dermatología, Instituto Valenciano de Oncología, València, Facultad de Medicina, Universidad Católica de Valencia San Vicente Mártir, València, España
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Pastor-Tomás N, Bañuls J, Nagore E. [Translated article] Clinical Relevance of Cherry Angiomas. Actas Dermosifiliogr 2023; 114:T240-6. [PMID: 36690145 DOI: 10.1016/j.ad.2022.10.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/24/2022] [Indexed: 01/22/2023] Open
Abstract
Cherry angiomas are the most common vascular tumors of the skin. They are particularly prevalent in the general population and become more common with age. Although an association with cancer was suggested at the end of the 19th century, when these tumors were first described, it could not be demonstrated. For many decades, therefore, cherry angiomas were considered to have no clinical relevance other than their association with age. A number of studies in recent years, however, have shown a link between cherry angiomas and exposure to various toxic substances and medications, benign and malignant diseases, and immunosuppression, rekindling interest in these lesions and providing clues for a better understanding of their etiology, pathophysiology, and clinical relevance.
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Bellinato F, Rosina P, Tonin B, Gisondi P, Girolomoni G. Predictors of subsequent primary melanoma: a case-control study. Arch Dermatol Res 2022; 314:881-885. [PMID: 34825952 DOI: 10.1007/s00403-021-02309-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 08/18/2021] [Accepted: 11/16/2021] [Indexed: 10/19/2022]
Abstract
Patients with history of malignant melanoma (MM) are at risk of developing subsequent primary MM (SPM). Predictors of SPM may be helpful to identify patients at higher risk. The objective of the study is to investigate the phenotypic traits, indirect actinic exposure features and pathological variables associated with the risk of development of SPM. A ten-year retrospective case-control study was undertaken involving patients following MM excision who underwent regular video-dermoscopic examination at 4-6-month intervals for the first 5 years, followed by annual dermoscopic examination for the following five years. Patients with only one primary cutaneous MM were compared with those who developed at least one SPM. A total of 577 patients were included, 309 (53.6%) men and 268 (46.5%) women (mean age, 55 ± 15 years), comprising 450 patients with single melanoma and 127 with at least one SPM. The median time span to the SPM was 30 (IQR 12-53) months. Compared to the first melanoma, SPM were thinner, mean Breslow 0.56 ± 0.64 mm vs 1.37 ± 1.83 mm (p < 0.001); in situ MM prevalence 12% vs 36% (p < 0.001). 36 % of the patients with SPM developed it in the anatomical site of the previous melanoma. At multivariate analysis, having numerous naevi (i.e. 10-50 nevi) OR = 2.88 (95% CI 1.32-6.28, previous dysplastic naevi excisions OR = 2.51 (95% CI 1.53-4.12), solar lentigo OR = 2.68 (95% CI 1.67-4.31) and actinic keratosis OR = 3.09 (95% CI 1.64-4.31) were associated with an increased risk of SPM. These features may identify persons at increased risk of developing SPM.
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Affiliation(s)
- Francesco Bellinato
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, Italy.
| | - Paolo Rosina
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, Italy
| | - Beatrice Tonin
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, Italy
| | - Paolo Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, Italy
| | - Giampiero Girolomoni
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, Italy
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8
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Farabi B, Bostanci S, Akay BN, Caliskan D, Atak MF. Comparison of phenotypic features in patients with single vs multiple primary cutaneous melanomas: a prospective single-center study. Int J Dermatol 2022; 62:66-72. [PMID: 36254676 DOI: 10.1111/ijd.16432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 08/07/2022] [Accepted: 09/20/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND There is sparse data regarding total body nevus count (TBNC), nevus count in specific locations, phenotypic factors, anthropometric indices, sunburn, and the relation to multiple primary cutaneous melanomas (MPCM) development. We aim to compare these variables in a cohort of patients diagnosed with single primary melanoma (SPM) and MPCM with histologic diagnoses of melanoma in situ, superficial spreading, and nodular melanoma in our clinic. METHODS Prospective observational studies for the evaluation of nevus counts in biopsy-proven melanoma patients from 2017 to 2020 at Ankara University were conducted. Age, gender, family history of melanoma, increased sun exposure, nonmelanoma skin cancers (NMSC), height, sunburn history, TBNC, and nevi count in specific anatomical locations were evaluated by multivariate logistic regression analysis. RESULTS A total number of 156 patients consisting of 22 MPCM and 134 SPM were included. Mean TBNC for SPM vs MPCM patients were 96.87 (SD ± 124.71) vs 247.00 (SD ± 261.58), respectively (P < 0.0001). TBNC was correlated to the left arm, trunk, lower extremity, and head and neck nevus counts but not with the right arm nevus count. Multiple regression analysis showed that having more than 10 nevi on the head and neck area is associated with MPCM (OR, 3.882 [95% CI, 1.084-13.899]). TBNC and nevus count in specific locations were found to be significantly higher in MPCM. CONCLUSION The risk of MPCM was associated with having ≥10 nevi on the head and neck.
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Affiliation(s)
- Banu Farabi
- Dermatology Department, New York Medical College, Metropolitan Hospital Center, New York, NY, USA
| | - Seher Bostanci
- Dermatology Department, Ankara University School of Medicine, Ankara, Turkey
| | - Bengu Nisa Akay
- Dermatology Department, Ankara University School of Medicine, Ankara, Turkey
| | - Deniz Caliskan
- Public Health Department, Ankara University, Ankara, Turkey
| | - Mehmet Fatih Atak
- Dermatology Department, Ankara University School of Medicine, Ankara, Turkey
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Sun H, Li Y, Zeng F, Meng Y, Du S, Deng G. Melanoma survivors are at increased risk for second primary keratinocyte carcinoma. Int J Dermatol 2022; 61:1397-1404. [PMID: 35726477 DOI: 10.1111/ijd.16309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/15/2022] [Accepted: 05/26/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Recent large cohorts have reported that melanoma survivors are at risk of developing second keratinocyte carcinoma (KC). However, the detailed proportion and risk are still unknown. We aimed to comprehensively analyze the risk of developing keratinocyte carcinoma after primary melanoma. METHODS We conducted systematic literature research in PubMed, Embase, Web of Science, and Cochrane Library published prior to September 13, 2021. Proportion and standardized incidence ratios (SIR) with its corresponding 95% confidence interval (CI) were pooled for assessing the risk. RESULTS A total of 15 studies encompassing 168,286 patients were included in our analysis. The pooled proportions of melanoma survivors that developed a subsequent basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and KC were 4.11% (95% CI, 1.32-6.90), 2.54% (95% CI, 1.78-3.31), and 5.45% (95% CI, 3.06-7.84), respectively. The risks of developing a second BCC, SCC, and KC in melanoma survivors were 5.3-fold (SIR 5.30; 95% CI, 4.87-5.77), 2.6-fold (SIR 2.58; 95% CI, 1.33-5.04), and 6.2-fold (SIR 6.17; 95% CI, 3.66-10.39) increased in comparison with the general population. Both fixed effects and random effects models were applied in conducting meta-analysis and reached a consistent conclusion. CONCLUSIONS Our results indicated melanoma survivors are at elevated risk of experiencing second primary BCC and SCC, which suggested the significance of surveillance for second primary KC and efforts for prevention in patients with a history of melanoma.
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Affiliation(s)
- Huiyan Sun
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Department of Oncology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China
| | - Yayun Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Department of Oncology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Furong Zeng
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Department of Oncology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yu Meng
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Department of Oncology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Songtao Du
- Department of Colorectal Surgical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Guangtong Deng
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Department of Oncology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Palacios-Diaz RD, de Unamuno-Bustos B, Abril-Pérez C, Pozuelo-Ruiz M, Sánchez-Arraez J, Torres-Navarro I, Botella-Estrada R. Multiple Primary Melanomas: Retrospective Review in a Tertiary Care Hospital. J Clin Med 2022; 11:2355. [PMID: 35566480 PMCID: PMC9105033 DOI: 10.3390/jcm11092355] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/05/2022] [Accepted: 04/19/2022] [Indexed: 11/23/2022] Open
Abstract
Multiple primary melanomas (MPM) refer to the occurrence of more than one synchronous or metachronous melanoma in the same individual. The aim of this study was to identify the frequency of MPM and describe the clinical and histopathologic characteristics of patients with MPM. An observational single-center retrospective study was designed based on a cohort of melanoma patients followed in a tertiary care hospital. Fifty-eight (8.9%) patients developed MPM. Most patients were men (65.5%) and the median age at the time of diagnosis of the first melanoma was 71 years old. The median time of diagnosis of the second melanoma from the first melanoma was 10.9 months, and 77.6% of second melanomas were diagnosed within the first 5 years. In total, 29 (50%) and 28 (48.3%) first and second melanomas were located in the trunk, respectively. Concordance of anatomic site between primary and subsequent melanoma was found in 46.6% of the patients. Proportion of in situ melanomas was increasingly higher in subsequent melanomas (from 36.21% of first melanomas to 100% of fifth melanomas). An increasing rate of melanomas with histological regression was observed within subsequent melanomas (from 60.3% of first melanomas to 80% of third melanomas). Our results support the importance of careful long-term follow-up with total body examination in melanoma patients.
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Affiliation(s)
- Rodolfo David Palacios-Diaz
- Department of Dermatology, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (R.D.P.-D.); (C.A.-P.); (M.P.-R.); (J.S.-A.); (I.T.-N.); (R.B.-E.)
| | - Blanca de Unamuno-Bustos
- Department of Dermatology, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (R.D.P.-D.); (C.A.-P.); (M.P.-R.); (J.S.-A.); (I.T.-N.); (R.B.-E.)
| | - Carlos Abril-Pérez
- Department of Dermatology, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (R.D.P.-D.); (C.A.-P.); (M.P.-R.); (J.S.-A.); (I.T.-N.); (R.B.-E.)
| | - Mónica Pozuelo-Ruiz
- Department of Dermatology, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (R.D.P.-D.); (C.A.-P.); (M.P.-R.); (J.S.-A.); (I.T.-N.); (R.B.-E.)
| | - Javier Sánchez-Arraez
- Department of Dermatology, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (R.D.P.-D.); (C.A.-P.); (M.P.-R.); (J.S.-A.); (I.T.-N.); (R.B.-E.)
| | - Ignacio Torres-Navarro
- Department of Dermatology, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (R.D.P.-D.); (C.A.-P.); (M.P.-R.); (J.S.-A.); (I.T.-N.); (R.B.-E.)
| | - Rafael Botella-Estrada
- Department of Dermatology, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (R.D.P.-D.); (C.A.-P.); (M.P.-R.); (J.S.-A.); (I.T.-N.); (R.B.-E.)
- Department of Medicine, Universitat de València, 46010 Valencia, Spain
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Li FW, Luo SK. Identification and Construction of a Predictive Immune-Related lncRNA Signature Model for Melanoma. Int J Gen Med 2021; 14:9227-9235. [PMID: 34880662 PMCID: PMC8647169 DOI: 10.2147/ijgm.s340025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 11/25/2021] [Indexed: 01/18/2023] Open
Abstract
Objective The occurrence and development mechanisms of melanoma are related to immunity and lncRNAs. Therefore, it is necessary to systematically explore immune-related lncRNA profiles to help improve the prognosis of melanoma. Methods We integrated immune-related lncRNAs and the basic clinical information of melanoma patients in the TCGA dataset. Immune-associated lncRNAs were selected by differential expression screening and enriched for analysis. After univariate and multivariate Cox regression analyses, a new prognostic indicator based on immune-associated lncRNAs was established. Results Overall, differentially expressed immune-related lncRNAs were significantly associated with clinical outcomes in patients with melanoma. A prognostic model was then established based on 14 immune-associated lncRNAs (LRRC8C-DT, AC021188.1, MALINC1, CCR5AS, EIF2AK3-DT, AC022306.2, AC242842.1, AL034376.1, AL662844.4, AC009065.3, AC099811.3, AC125807.2, SPINT1-AS1 and AC009495.2). Melanoma patients in the high-risk group had worse overall survival than those in the low-risk group. The AUC of the risk score was 0.786. Conclusion This study identified several clinically significant immune-related lncRNAs and established a relevant prognostic model, which provided a molecular analysis of immunity in melanoma and potential prognostic lncRNAs for melanoma.
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Affiliation(s)
- Fang-Wei Li
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, 510317, People's Republic of China
| | - Sheng-Kang Luo
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, 510317, People's Republic of China
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Salgüero Fernández I, Palma Marti L, Nájera Botello L, Roustan Gullón G. Clinical and Histologic Features of Multiple Primary Melanoma in a Series of 31 Patients. Actas Dermo-Sifiliográficas (English Edition) 2021. [DOI: 10.1016/j.adengl.2020.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Borghi A, Dika E, Maietti E, Scuderi V, Forconi R, Patrizi A, Corazza M. Eruptive Cherry Angiomas and Skin Melanoma: Further Insights into an Intriguing Association. Dermatology 2020; 237:981-987. [PMID: 33254169 DOI: 10.1159/000511101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/21/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Some risk factors for malignant melanoma (MM) are recognized. OBJECTIVE To compare the strength of association between MM and eruptive cherry angiomas (CAs) with that of other well-known associations. METHODS This cross-sectional study included all subjects referred to the Outpatient Dermatology-Oncology and Dermoscopy Units of the Universities of Ferrara and Bologna, Italy, over a 5-month period and submitted to total body skin examination. We recorded: age, sex, cutaneous and non-cutaneous malignancies, presence of CAs, arbitrarily considered as "eruptive" when >10, >40 common melanocytic naevi or >2 clinically atypical naevi. The strength of association between the possible risk factors and MM was calculated by odds ratio in both the whole population and age quartiles. Variables associated with MM were included in multiple logistic regression analysis. RESULTS 1,190 subjects were included; 615 had malignant skin tumours, 462 MM, 85 extracutaneous tumours. Five hundred and eighty-seven subjects had eruptive CAs, 485 subjects >40 melanocytic naevi and 368 more than 2 atypical melanocytic naevi. Eruptive CAs, especially in subjects younger than 70, and >2 atypical melanocytic naevi, mostly in subjects older than 50, were significantly associated with MM. The strength of these 2 associations was similar. The presence of >40 melanocytic naevi was not associated with MM. CONCLUSIONS These findings confirmed an association between MM and eruptive CAs, which was as strong as the one between MM and >2 atypical melanocytic naevi. CAs seem an intriguing model of interaction between heterogeneous variables, like immunocompetence, stimuli inducing endothelial cell proliferation, and oncogenesis, which deserves further investigation.
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Affiliation(s)
- Alessandro Borghi
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy,
| | - Emi Dika
- Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Elisa Maietti
- Center for Clinical Epidemiology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Valeria Scuderi
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Riccardo Forconi
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Annalisa Patrizi
- Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Monica Corazza
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
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14
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Ungureanu L, Zboraș I, Vasilovici A, Vesa Ș, Cosgarea I, Cosgarea R, Șenilă S. Multiple primary melanomas: Our experience. Exp Ther Med 2020; 21:88. [PMID: 33363599 PMCID: PMC7725020 DOI: 10.3892/etm.2020.9520] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 10/02/2020] [Indexed: 01/28/2023] Open
Abstract
Patients with melanoma have an increased risk of having other neoplasms, and particularly other melanomas and non-melanoma skin cancers. The study aimed to describe multiple primary melanomas in a large medical university centre from Romania (Cluj-Napoca) from 2004 to 2020. Out of 699 patients with melanoma included in the study, 26 (3.71%) developed multiple tumours. The 26 patients developed a total of 59 melanomas, corresponding to a mean of 2.3 melanomas per patient. The site and histological subtype of the first and second melanomas were not consistent. The proportion of subsequent melanomas that were in situ (51.5%) or thin melanomas (<1 mm, 24.2%) was higher compared with first melanomas (7.7%, respectively 11.5%). The median and mean time to diagnosis was 2.75 months, respectively, 28.09 months. In total, 76.92% of second melanomas were detected within three years, but we were able to document a subsequent melanoma more than ten years after the first diagnosis. The study highlights the importance of follow-up in patients diagnosed with melanoma, not only in the first years after the primary diagnoses but for the entire life.
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Affiliation(s)
- Loredana Ungureanu
- Department of Dermatology, 'Iuliu Hațieganu' University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Iulia Zboraș
- Department of Dermatology, 'Iuliu Hațieganu' University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Alina Vasilovici
- Department of Dermatology, 'Iuliu Hațieganu' University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Ștefan Vesa
- Department of Pharmacology, 'Iuliu Hațieganu' University of Medicine and Pharmacy, Toxicology and Clinical Pharmacology, 400012 Cluj-Napoca, Romania
| | - Ioana Cosgarea
- Institute of Cellular Medicine, University of Newcastle, Newcastle upon Tyne NE2 4HH, UK
| | - Rodica Cosgarea
- Department of Dermatology, 'Iuliu Hațieganu' University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Simona Șenilă
- Department of Dermatology, 'Iuliu Hațieganu' University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
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Salgüero Fernández I, Palma Marti L, Nájera Botello L, Roustan Gullón G. Clinical and Histologic Features of Multiple Primary Melanoma in a Series of 31 Patients. Actas Dermosifiliogr (Engl Ed) 2020; 112:52-58. [PMID: 32950483 DOI: 10.1016/j.ad.2020.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 09/01/2020] [Accepted: 09/01/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND We reviewed all cases of multiple primary melanoma diagnosed at our department over a 32-year period (1987-2019) to better characterize this subgroup of patients and develop a tailored protocol to offer them closer follow-up. METHODS Retrospective, observational, descriptive study of patients diagnosed with multiple primary melanoma at a tertiary care hospital between January 1987 and March 2019. We collected clinical, epidemiologic, and histologic characteristics of primary and subsequent melanomas and performed a descriptive analysis. RESULTS Thirty-one patients (15 men and 16 women) with a median age of 67years (range, 36-85years) were included. Second primary melanomas were diagnosed after a median of 2years (range, 0-4years). The median number of melanomas per patient was 2 (range, 2-6). Twenty-three of the 31 patients, 25 had 2 primary melanomas (80%), 4 had 3 melanomas (13%), and 2 patients each had 5 and 6 primary melanomas. Subsequent melanomas were less invasive than the initial primary melanomas. Median Breslow thickness was 1mm (range, 0.67-4mm) for the first primary melanoma and 0.5mm (range, 0.32-2.42mm) for subsequent melanomas. CONCLUSIONS Subsequent melanomas are thinner than primary melanomas. We observed an increase in the number of cases of multiple primary melanoma diagnosed in the last 2years of our study. Our findings highlight the importance of close, long-term follow-up of patients.
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Affiliation(s)
- I Salgüero Fernández
- Servicio de Dermatología, Hospital Puerta de Hierro, Majadahonda, Madrid, España.
| | - L Palma Marti
- Hospital Puerta de Hierro, Majadahonda, Madrid, España
| | - L Nájera Botello
- Servicio de Anatomía Patológica, Hospital Puerta de Hierrro, Majadahonda, Madrid, España
| | - G Roustan Gullón
- Servicio de Dermatología, Hospital Puerta de Hierro, Majadahonda, Madrid, España
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Villani A, Fabbrocini G, Costa C, Greco V, Scalvenzi M. Second primary melanoma: incidence rate and risk factors. J Eur Acad Dermatol Venereol 2020; 34:e623-e624. [PMID: 32314450 DOI: 10.1111/jdv.16500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A Villani
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Federico II, Naples, Italy
| | - G Fabbrocini
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Federico II, Naples, Italy
| | - C Costa
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Federico II, Naples, Italy
| | - V Greco
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Federico II, Naples, Italy
| | - M Scalvenzi
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Federico II, Naples, Italy
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