Giant hanging melanoma of the eyelid skin

Pai, Radha R.; Kini, Hema; Kamath, Sai Giridhar; Kumar, Suneet

doi:10.4103/0301-4738.40367

Cited by 9 publications

(11 citation statements)

References 4 publications

(11 reference statements)

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“…This pattern of local spread without distant disease in such massive melanomas was also noted in several other case reports1 , 4 , 5 found on review of the literature. Conventional sized melanomas are thought to follow a paradigm of orderly disease progression from primary site to regional lymph nodes and subsequently to distant sites 13 – 15.…”

Section: Discussionsupporting

confidence: 84%

“…A review of the recent literature demonstrates isolated case reports which describe patients who present with giant melanomas of various anatomic sites, including the back,1 , 2 abdomen,3 scalp,4 eyelid5 and thumb 6. To our knowledge, patient B—who had a 19 cm diameter lesion—represents the largest primary melanoma of the upper extremity and one of the largest melanomas of all reported to date.…”

Section: Discussionmentioning

confidence: 99%

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Giant cutaneous melanomas: evidence for primary tumour induced dormancy in metastatic sites?

Tseng¹,

Doyle²,

Maguiness³

et al. 2009

Case Reports

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Two patients with giant, 8 cm and 19 cm melanomas of the upper extremity, respectively, are presented and discussed. Both patients had neglected their tumours and sought medical attention only after the appearance of distressing symptoms (for example, bleeding). Palpable lymph nodes were found on physical examination but no evidence of distant metastases was noted on imaging studies despite such enormous primary tumours. Both patients underwent aggressive treatment, including complete surgical resection of the primary tumour and ipsilateral axillary lymph node dissection. One patient had no evidence of local recurrence, but developed metastatic disease at 6 months follow-up. The other patient developed local recurrence and distant metastases within 2 months of resection.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Giant cutaneous melanomas: evidence for primary tumour induced dormancy in metastatic sites?

Tseng¹,

Doyle²,

Maguiness³

et al. 2009

Case Reports

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“…It is likely that surgery may be one of many potential stimuli, such as radiation therapy, immunosuppression, or systemic illness/infection that can permit escape. Giant melanomas without clinically apparent distant metastases, as in our two patients and others [18,60-62], may represent a unique situation for the clinician to be aware of. Whether dormant tumor cells were truly present at distant metastatic sites preoperatively or primary tumor cells were disseminated systemically through surgical manipulation, these patients would likely benefit from immediate postoperative chemotherapy or perhaps anti-angiogenesis treatment (e.g., bevacizumab) or immunotherapy to counter development of metastatic disease.…”

Section: Discussionmentioning

confidence: 62%

“…We hypothesized that at this point in disease progression, dormant tumor cells at distant metastatic sites were actually present; development of clinically detectable disease then occurred rapidly, at two and six months after primary tumor resection and regional lymph node dissection. Several others have reported similar observations in cases of giant melanomas [60-62]. Although we were limited in direct experimental data to support this, we hypothesized that primary tumor resection may have removed the source of endogenous angiogenesis inhibitors or modified the immune regulatory mechanisms, allowing for escape from tumor dormancy and malignant outgrowth at distant metastatic sites.…”

Section: Does Surgery Induce Escape From Tumor Dormancy In Melanoma?mentioning

confidence: 58%

Metastatic Tumor Dormancy in Cutaneous Melanoma: Does Surgery Induce Escape?

Tseng

Fadaki

Leong³

2011

Cancers

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According to the concept of tumor dormancy, tumor cells may exist as single cells or microscopic clusters of cells that are clinically undetectable, but remain viable and have the potential for malignant outgrowth. At metastatic sites, escape from tumor dormancy under more favorable local microenvironmental conditions or through other, yet undefined stimuli, may account for distant recurrence after supposed “cure” following surgical treatment of the primary tumor. The vast majority of evidence to date in support of the concept of tumor dormancy originates from animal studies; however, extensive epidemiologic data from breast cancer strongly suggests that this process does occur in human disease. In this review, we aim to demonstrate that metastatic tumor dormancy does exist in cutaneous melanoma based on evidence from mouse models and clinical observations of late recurrence and occult transmission by organ transplantation. Experimental data underscores the critical role of impaired angiogenesis and immune regulation as major mechanisms for maintenance of tumor dormancy. Finally, we examine evidence for the role of surgery in promoting escape from tumor dormancy at metastatic sites in cutaneous melanoma.

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“…Large melanoma masses have rarely been reported in the literature, mainly because patients tend to come for treatment early before the tumor enlarges and practitioners are well aware of the catastrophic consequences of neglecting such tumors 1 . In the available literature, we found ten reports of malignant melanoma that presented as a giant mass [1][2][3][4][5][6][7][8][9][10] . Of these, three cases were nodular melanomas [1][2][3] , two were giant congenital melanocytic nevi 4,5 and one was a metastatic melanoma 6 .…”

Section: Discussionmentioning

confidence: 99%

Giant Acral Melanoma on the Left Thumb of a Korean Patient

et al. 2009

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Department of Dermatology, College of Medicine, Korea University, Seoul, KoreaThe acral regions of the limbs of Asians are predisposed to develop malignant melanoma, but giant-sized acral melanoma has not been previously reported in the Asian population. Giant-sized melanoma implies aggressive tumor invasion and so it is more difficult to achieve a therapeutic cure. A 56-year-old woman presented with a giant acral melanoma of the left thumb with concomitant bone destruction and axillary lymph node metastasis. The initial lesion was a subungual black macule on the left thumb that had grown into a giant 7.0×4.0×3.5 cm-sized melanoma over a 3 year period. The left thumb was amputated and the axillary lymph nodes were completely dissected. During the ensuing 3 months, she underwent adjuvant treatment with interferon-alpha-2a. The interesting feature of this case is that the large melanoma mass of this patient, which was accompanied with adjacent bone destruction and lymph node metastasis, had developed rapidly from a small black macule in the nail matrix, and this black macule was suspected to be a subungual melanoma.

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Giant hanging melanoma of the eyelid skin

Cited by 9 publications

References 4 publications

Giant cutaneous melanomas: evidence for primary tumour induced dormancy in metastatic sites?

Giant cutaneous melanomas: evidence for primary tumour induced dormancy in metastatic sites?

Metastatic Tumor Dormancy in Cutaneous Melanoma: Does Surgery Induce Escape?

Giant Acral Melanoma on the Left Thumb of a Korean Patient

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