Melanoma in situ

Higgins, H. William; Lee, Kachiu C.; Galan, Anjela; Leffell, David J.

doi:10.1016/j.jaad.2015.03.057

Cited by 66 publications

(34 citation statements)

References 115 publications

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“…In some cases, wide margin excision cannot be achieved due to proximity to vital anatomical structures such as nerves or blood vessels, or when severe cosmetic issues evolve, especially in the head and neck region. In these cases second-line treatments as topical agents, intralesional alpha-interferon, radiation, and laser therapy are being explored as adjuncts to surgery, although their efficacy is not yet undoubtedly proven [28]. For these patients, for whom wide margin excision could not be achieved, CAPJ therapy might prove to be an appealing alternative.…”

Section: Discussionmentioning

confidence: 99%

“…Most cases of malignant melanoma are diagnosed at an early stage, when surgical excision can be curative. In some cases, however, the tumor cannot be completely excised due to its proximity to vital anatomical structures such as nerves and blood vessels [28]. In these cases, where drug treatment or radiation therapy are mandated, CAPJ treatment may be an attractive option.…”

Section: Introductionmentioning

confidence: 99%

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Cold Atmospheric Plasma, Created at the Tip of an Elongated Flexible Capillary Using Low Electric Current, Can Slow the Progression of Melanoma

et al. 2017

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IntroductionCold Atmospheric Plasma Jet (CAPJ), with ion temperature close to room temperature, has tremendous potential in biomedical engineering, and can potentially offer a therapeutic option that allows cancer cell elimination without damaging healthy tissue. We developed a hand-held flexible device for the delivery of CAPJ to the treatment site, with a modified high-frequency pulse generator operating at a RMS voltage of <1.2 kV and gas flow in the range 0.3–3 l/min. The aims of our study were to characterize the CAPJ emitted from the device, and to evaluate its efficacy in elimination of cancer cells in-vitro and in-vivo.Methods and ResultsThe power delivered by CAPJ was measured on a floating or grounded copper target. The power did not drastically change over distances of 0–14 mm, and was not dependent on the targets resistance. Temperature of CAPJ-treated target was 23°-36° C, and was dependent on the voltage applied. Spectroscopy indicated that excited OH- radicals were abundant both on dry and wet targets, placed at different distances from the plasma gun. An in-vitro cell proliferation assay demonstrated that CAPJ treatment of 60 seconds resulted in significant reduction in proliferation of all cancer cell lines tested, and that CAPJ activated medium was toxic to cancer cells. In-vivo, we treated cutaneous melanoma tumors in nude mice. Tumor volume was significantly decreased in CAPJ-treated tumors relatively to controls, and high dose per fraction was more effective than low dose per fraction treatment. Importantly, pathologic examination revealed that normal skin was not harmed by CAPJ treatment.ConclusionThis preliminary study demonstrates the efficacy of flexible CAPJ delivery system against melanoma progression both in-vitro and in-vivo. It is envisioned that adaptation of CAPJ technology for different kinds of neoplasms use may provide a new modality for the treatment of solid tumors.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cold Atmospheric Plasma, Created at the Tip of an Elongated Flexible Capillary Using Low Electric Current, Can Slow the Progression of Melanoma

et al. 2017

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“…Another potential explanation for inconsistencies in recommendations and national guidelines may be changes in the treatment of melanoma over time, as evidenced by the Surveillance, Epidemiology, and End Results (SEER) data. 46–48 From 1973–1985, the majority of melanoma in situ cases were treated with excisional biopsy. In contrast, from 1996–2006, the majority of melanoma in situ cases were treated with <1cm excisional margins, which is consistent with NCCN treatment guidelines.…”

Section: Discussionmentioning

confidence: 99%

Variation among pathologists' treatment suggestions for melanocytic lesions: A survey of pathologists

Lee

Peacock

Weinstock

et al. 2017

Journal of the American Academy of Dermatology

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Background The extent of variability in treatment suggestions for melanocytic lesions made by pathologists is unknown. Objective We investigated how often pathologists rendered suggestions, reasons for providing suggestions, and concordance with national guidelines. Methods We conducted a cross-sectional survey of pathologists. Data included physician characteristics, experience, treatment recommendation practices. Results Of 301 pathologists, 207 (69%) from 10 states (CA, CT, HI, IA, KY, LA, NJ, NM, UT, WA), enrolled. Fifteen percent and 7% reported never and always including suggestions, respectively. Reasons for offering suggestions included improved care (79%), clarification (68%), and legal liability (39%). Reasons for not offering suggestions included referring physician preference (48%), lack of clinical information (44%), and expertise (29%). Training and caseload were associated with offering suggestions (p<0.05). Physician suggestions were most consistent for mild/moderate dysplastic nevi and melanoma. For melanoma in-situ, 18 (9%) and 32 (15%) pathologists made suggestions that under- or over-treated lesions based on NCCN guidelines, respectively. For invasive melanoma, 14 (7%) of pathologists made treatment suggestions that under-treated lesions based on NCCN guidelines. Limitations Treatment suggestions were self-reported. Conclusions Pathologists made recommendations ranging in consistency. These findings may inform efforts to reduce treatment variability and optimize patterns of care delivery for patients.

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“…Clinical subtypes of in situ melanoma include lentigo maligna, superficial spreading, acral lentiginous, and mucosal. The pathology shows a pagetoid spread of the tumor cells demonstrated by a proliferation of single cells or groups of atypical melanocytes along the basal layer of the epidermis or throughout the epidermis into the granular or horny layers or both [ 1 - 2 ]. The tumors from both the patients in this report had these pathologic features.…”

Section: Discussionmentioning

confidence: 99%

Linear Malignant Melanoma In Situ: Reports and Review of Cutaneous Malignancies Presenting as Linear Skin Cancer

Cohen

2017

Cureus

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Melanomas usually present as oval lesions in which the borders may be irregular. Other morphological features of melanoma include clinical asymmetry, variable color, diameter greater than 6 mm and evolving lesions. Two males whose melanoma in situ presented as linear skin lesions are described and cutaneous malignancies that may appear linear in morphology are summarized in this report. A medical literature search engine, PubMed, was used to search the following terms: cancer, cutaneous, in situ, linear, malignant, malignant melanoma, melanoma in situ, neoplasm, and skin. The 25 papers that were generated by the search and their references, were reviewed; 10 papers were selected for inclusion. The cancer of the skin typically presents as round lesions. However, basal cell carcinoma and squamous cell carcinoma may arise from primary skin conditions or benign skin neoplasms such as linear epidermal nevus and linear porokeratosis. In addition, linear tumors such as basal cell carcinoma can occur. The development of linear cutaneous neoplasms may occur secondary to skin tension line or embryonal growth patterns (as reflected by the lines of Langer and lines of Blaschko) or exogenous factors such as prior radiation therapy. Cutaneous neoplasms and specifically melanoma in situ can be added to the list of linear skin lesions.

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Melanoma in situ

Cited by 66 publications

References 115 publications

Cold Atmospheric Plasma, Created at the Tip of an Elongated Flexible Capillary Using Low Electric Current, Can Slow the Progression of Melanoma

Cold Atmospheric Plasma, Created at the Tip of an Elongated Flexible Capillary Using Low Electric Current, Can Slow the Progression of Melanoma

Variation among pathologists' treatment suggestions for melanocytic lesions: A survey of pathologists

Linear Malignant Melanoma In Situ: Reports and Review of Cutaneous Malignancies Presenting as Linear Skin Cancer

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