Immediate Local and Regional Recurrence After the Excision of a Polypoid Melanoma: Tumor Dormancy or Tumor Activation?

Giorgi, Vincenzo De; Massi, Daniela; Gerlini, Gianni; Mannone, Francesca; Quercioli, Elena; Carli, Paolo

doi:10.1046/j.1524-4725.2003.29163.x

Cited by 25 publications

(30 citation statements)

References 15 publications

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“…1,4,7,9,10 All cases are shown in Table 1, with the indication of sex, age, race, tumor dimensions, soft tissue invasion, sentinel lymph node, lymphatic and visceral metastasis, primary/adjuvant treatment, and follow-up. Despite the effort to collect as much information as possible, it appears that few clinical and surgical tips are available because of high-specialist journals pertinent to the pathologic and microscopic features.…”

Section: Resultsmentioning

confidence: 99%

“…5Y7 The main concern regards the differentiation from the sessile polypoid melanoma that lies at least half above the skin surface. 7 It is common on mucosae including the upper respiratory tract, esophagus, vagina, and rectum and behaves as a level IV or V tumor with a very rapid progression and poor prognosis.…”

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confidence: 99%

“…7 The incidence reported in the medical literature varies from 2% to 43%. 2 Clinically, it shows a rapid growth, taking only few weeks to became huge.…”

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confidence: 99%

“…Morphologically, it shows marked cytologic atypia, cellular and nuclear pleomorphism, organization in large sheets of cells, and high mitotic rate. 7,8 …”

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confidence: 99%

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Head and Neck Polypoid Melanoma

Dini¹,

Quercioli²,

Caldarella³

et al. 2012

Journal of Craniofacial Surgery

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Polypoid melanoma represents a rare clinical variant of nodular melanoma skin cancer in which the tumor is connected to the skin by a pedicle, characterized by exophytic growth, ulceration, and young age at onset (20Y39 years) with a special predilection for the back and with a survival rate at 5 years ranging from 32% to 42% as compared with 57% 5-year survival for nodular subtype and 77% for the superficial subtype. We present a case of a deeply pigmented polypoid melanoma arising on the face of a 77-year-old man. We performed a literature review to clarify its surgical management and prognosis.Key Words: Melanoma, polypoid melanoma, pedunculated melanoma, sentinel node biopsy, review P olypoid melanoma, first classified in 1958 by Vogler and coworkers, is a type of melanoma characterized by exophytic thickness, usual ulceration, and young age at onset (20Y39 years) with a special predilection for the back and with a survival rate at 5 years ranging from 32% to 42% as compared with 57% 5-year survival for nodular subtype and 77% for the superficial subtype. 1Y4 As previously asserted, it should be specified that the term ''pedunculated'' is different from ''polypoid''; according to McGovern et al, 2 polypoid melanoma is classified as pedunculated when the lesion is entirely above the skin surface and connected to the skin by a stalk. 5Y7 The main concern regards the differentiation from the sessile polypoid melanoma that lies at least half above the skin surface.7 It is common on mucosae including the upper respiratory tract, esophagus, vagina, and rectum and behaves as a level IV or V tumor with a very rapid progression and poor prognosis.1Y3 It has been postulated that the poor prognosis would be related to the high risk of vascular embolism under the lesion. 7 The incidence reported in the medical literature varies from 2% to 43%.2 Clinically, it shows a rapid growth, taking only few weeks to became huge. Morphologically, it shows marked cytologic atypia, cellular and nuclear pleomorphism, organization in large sheets of cells, and high mitotic rate. 7,8 CLINICAL REPORTWe report a case of a polypoid melanoma arising on the face of a 77-year-old man with characteristic features and clinical course. The lesion developed in few weeks and was characterized by rapid

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

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Head and Neck Polypoid Melanoma

Dini¹,

Quercioli²,

Caldarella³

et al. 2012

Journal of Craniofacial Surgery

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“…Clinical data [41] suggest a delicate tumorimmune balance slightly in favor of the tumor, although, currently, immunostimulatory Interferon-α and IL-2 are approved as adjuvant therapy for melanoma.…”

Section: Melanomamentioning

confidence: 99%

Cancer as Multifaceted Disease

Friedman

2012

Math. Model. Nat. Phenom.

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Abstract. Cancer has recently overtaken heart disease as the world's biggest killer. Cancer is initiated by gene mutations that result in local proliferation of abnormal cells and their migration to other parts of the human body, a process called metastasis. The metastasized cancer cells then interfere with the normal functions of the body, eventually leading to death. There are two hundred types of cancer, classified by their point of origin. Most of them share some common features, but they also have their specific character. In this article we review mathematical models of such common features and then proceed to describe models of specific cancer diseases.

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Regulation of Tumor Dormancy and Role of Microenvironment: A Mathematical Model

Kim

Boushaba

2012

Advances in Experimental Medicine and Biology

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Herein, a mathematical model of a molecular control system for the regulation of secondary tumors is formulated and analyzed to explore how secondary tumors can be controlled by a primary tumor with/without a surgery and the microenvironment. This control system is composed of fibroblast growth factor-2 (FGF2), urokinase-type plasminogen activator (uPA), plasmin, transforming growth factor-beta (TGFβ), latent TGFβ (LTGFβ), and tumor density. The control of secondary tumors by primary tumors was first modeled by Boushaba, Nilsen-Hamiton and Levine in [46]. The model is based on the idea that the vascularization of a secondary tumor can be suppressed by inhibitors from a larger primary tumor. The emergence of tumors at secondary sites 5-7 cm from a primary site was observed after surgical removal of the primary tumor in silico. The model supports the notion that the fate of secondary tumors after surgery depends on the distance from the primary tumor and the surrounding microenvironment. As such, the primary tumor did not influence the growth of remote secondary tumors, but it could effectively suppress the growth of the secondary tumors if they were too close to the primary tumor, even after it was removed. Thus, the model predicts the emergence of secondary tumors after the excision of the primary tumor when the distance between these tumors is in the "distance window." It also predicts that the growth behaviors of the secondary tumors depend on the local microenvironment. Based on these findings, we propose several treatment options for better clinical outcomes.

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Immediate Local and Regional Recurrence After the Excision of a Polypoid Melanoma: Tumor Dormancy or Tumor Activation?

Cited by 25 publications

References 15 publications

Head and Neck Polypoid Melanoma

Head and Neck Polypoid Melanoma

Cancer as Multifaceted Disease

Regulation of Tumor Dormancy and Role of Microenvironment: A Mathematical Model

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