Malignant melanoma is a kind of highly malignant tumor, which mainly occurs in the skin, mucous membrane, and rarely in the breast. Here we reported a case of malignant melanoma in the chest wall skin with mammary metastasis. A sizable pigment spot on the skin of the thoracic region was found at the patient’s birth, existing for 50 years with quite atypical clinical manifestation. A nodule at 12 o’clock of the left breast was found by ultrasound four months ago, who was mistaken for a fibroadenoma. As a result, the patient received a minimally invasive excision of the breast lesion, after which the pathological report suggested malignant melanoma. By sharing this case, we aimed to discuss the diagnosis and treatment of this kind of atypical malignant melanoma in detail and provide some clinical experience.
ObjectiveTo study the advance of malignant anorectal melanoma. MethodsThe literature in recent years about risk factors,clinical characteristic,early diagnosis,treatment and the prognosis of the anorectal melanoma were reviewed.ResultsMalignant anorectal melanoma was very rare.The history of pigment naevus,human immunodeficiency virus infection and sunlight exposure might be the risk factors.Clinic characteristics were rectal bleeding,anorectal mass and changing in bowel habits.Early diagnosis mainly depended on performing routine examination on patients between the ages of 45-80 years.The staining for polycolnal CEA in anorectal melanoma has a role on diagnostic pathology.The treatment is controversial and the combined treatments of chemotherapy with radiation therapy and immunotherapy which were based on surgery (abdominoperineal resection or wide local excision) are introduced.Conclusion Early diagnosis of malignant anorectal melanoma is difficult and the prognosis is poor.It is necessary to pay more attention to this disease and the most successful therapeutic approaches need to be developed.
To explore the inhibitory effect of hydroxyapatite (HA) particles with different sizes on malignant melanoma A375 cells in vitro, we synthesized 4 short rod-like HA particles using TIPS. Their mean diameters were 998.0 nm (HA1), 511.0 nm (HA2), 244.0 nm (HA3), and 71.6 nm (HA4), respectively. Malignant melanoma A375 cells were co-cultured with HA particles in vitro. Results showed that HA particles smaller than 511.0 nm in mean diameter could always inhibit proliferation of A375 cells, and nanometer-HA particles (HA4) had the strongest inhibitory effect on A375 cell proliferation and the strongest inducing effect on apoptosis. HA particles were distributed in plasma of A375 cells. The ultrastructure changes of A375 cells were found most significant in nanometer-HA particles (HA4) group. We conclude that particle size is a very important influencing factor on anti-tumor effects of HA and that nanometer-HA particle has the strongest inhibitory effect on tumor cell proliferation.
Objective To compare the cl inical effectiveness of the medial plantar flap, the retrograde posterior tibial vascular flap, and the reverse sural neurocutaneous flap in repairing defect caused by resection of cutaneous mal ignant melanoma (CMM) in the heel region. Methods The cl inical data were retrospectively analysed from 24 patients with defect who had CMM in the heel region and were treated by radical excision and flap repairing between March 2007 and March 2010. Defects were repaired with the reverse sural neurocutaneous flaps of 8 cm × 7 cm-14 cm × 12 cm at size in 12 patients (groupA), with the medial plantar flaps of 6 cm × 5 cm-8 cm × 7 cm at size in 7 patients (group B), and with the retrograde posterior tibial vascular flaps of 9 cm × 7 cm-15 cm × 13 cm at size in 5 patients (group C). There was no significant difference in gender, age, duration of illness, cl inical stage, and size of CMM among 3 groups (Pgt; 0.05). The donor site was sutured directly or by free skin graft. Results No significant difference was found in the operation time and the intraoperative blood loss among 3 groups (P gt; 0.05). All skin flaps or grafts survived and wounds healed by first intention. The patients were followed up 1-3 years. The flaps had normal texture and color with no ulcer in 3 groups. At 1 year after operation, the sensory recovery rates of the flaps were 0, 100%, and 20% in groups A, B, and C, respectively, showing significant difference among 3 groups (P=0.001). The patients had normal appearance of heel and pain-free walking [10 (83%) in group A, 6 (86%) in group B, and 4 (80%) in group C] of heel region, showing no significant difference among 3 groups (χ2=40.000, P=0.135). Heel pain existed in weightbearing walking of 3 groups, and there were significant differences in visule analogue scale (VAS) score (Plt; 0.05). There was no significant difference in range of motion of ankle joint among 3 groups (P gt; 0.05). Except 1 patiant of relapse in group A at 1 month after operation, no relapse was observed in the other patients during follow-up. Conclusion The medial plantar flap, the retrograde posterior tibial vascular flap, and the reverse sural neurocutaneous flap can achieve the good cl inical effectiveness in treating heel defect caused by the resection of CMM. And the medial plantar flap is the first choice in small skin defect of heel area.
Objective To observe the effects of operation with large-dose of RoferonA for cutaneous malignant melanoma. Methods From January 1998 to December 2005, thirtythree patients with cutaneous malignant melanoma were treated. There were 20 males and 13 females, aging 17-79 years. The disease course was 2 months to 7 years. In 33 patients, nine patients identified as clinical-stage Ⅰ received singly enlargedresection to the primary lesion and performed split-thickness skin graft dermoplasty or adjacent skin flap repair; twenty-three patients identified as clinicalstage Ⅱ received enlargedresection to the primarylesion and performed proximal lymphaden scavenge as well as received split-thickness skin graft dermoplasty; and one patient identified as clinical-stage Ⅲ received palliative resection to the primary lesion. All patients received large dose of Roferon-A after operation. Results There are no recidivation in the 9 patients of clinicalstage Ⅰ. There are 1 recidivation and 1 quit in all the 23 patientsof clinicalstage Ⅱ. One patient of clinicalstage Ⅲ died after 18 months of operation. Conclusion The operation combined with large-dose of RoferonA after operation was a more effective way to treat cutaneous malignant melanoma.