Stage IV malignant melanoma of unknown primary site in a young man

Christopoulos, Petros; Doulias, Triantafyllos; Koutelidakis, Ioannis; Papaziogas, Bassileios

doi:10.1136/bcr-2012-006283

Cited by 4 publications

(5 citation statements)

References 11 publications

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“…One out of fifteen showed stable disease on chemotherapy, and one showed a partial response at the time of report. The remaining 13 patients experienced PD [32–36]. Other investigators reported survival data of MUP patients as a group rather than individually on chemotherapy.…”

Section: Resultsmentioning

confidence: 99%

Treatment Outcomes for Metastatic Melanoma of Unknown Primary in the New Era: A Single-Institution Study and Review of the Literature

Utter

Goldman²,

Weiss³

et al. 2017

Oncology

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Background: Metastatic melanoma of unknown primary (MUP) is uncommon, biologically ill defined, and clinically understudied. MUP outcomes are seldom reported in clinical trials. In this study, we analyze responses of MUP patients treated with systemic therapy in an attempt to inform treatment guidelines for this unique population. Methods: New York University (NYU)'s prospective melanoma database was searched for MUP patients treated with systemic therapy. PubMed and Google Scholar were searched for MUP patients treated with immunotherapy or targeted therapy reported in the literature, and their response and survival data were compared to the MUP patient data from NYU. Both groups' response data were compared to those reported for melanoma of known primary (MKP). Results: The MUP patients treated at NYU had better outcomes on immunotherapy but worse on targeted therapy than the MUP patients in the literature. The NYU MUP patients and those in the literature had worse outcomes than the majority-MKP populations in 10 clinical trial reports. Conclusions: Our study suggests that MUP patients might have poorer outcomes on systemic therapy as compared to MKP patients. Our cohort was small and limited data were available, highlighting the need for increased reporting of MUP outcomes and multi-institutional efforts to understand the mechanism behind the observed differences.

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Section: Resultsmentioning

confidence: 99%

Treatment Outcomes for Metastatic Melanoma of Unknown Primary in the New Era: A Single-Institution Study and Review of the Literature

Utter

Goldman²,

Weiss³

et al. 2017

Oncology

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“…Neri et al [35] reported on two cases, but only one of them was PMML. Christopoulos et al published a case of a stage IV malignant melanoma, with a pulmonary mass and cervical lymph node involvement [56]. Pathological analyses performed on the cervical lymph nodes excised led to diagnosis of melanoma, and the authors claimed that the primary tumor was a MM of unknown origin.…”

Section: Discussionmentioning

confidence: 99%

Primary Melanoma of the Lung: A Systematic Review

et al. 2020

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Background and Objectives: The respiratory apparatus, generally affected by highly aggressive tumors like lung cancer and mesothelioma, is rarely affected by primary malignant melanoma. The aim of this review was to identify cases of primary malignant melanoma of the lung (PMML) published in the modern scientific literature, and to describe their main clinical, pathological and therapeutic features. Materials and Methods: A systematic search of publications in the electronic database PubMed has been performed using keywords, and the references of the selected articles were checked to identify additional missing studies. Results: Globally 52 papers reporting on 76 cases were identified. Among them there were 47 reports of a single case, three papers reporting on two cases each, and two larger case series published in 1997 and 2005 including eight and 15 cases, respectively. Conclusions: PMML was generally diagnosed in middle-aged males, without any apparent correlation with cigarette smoking. It was more frequently found in the lower lobes and the left lung. The tumors were generally pigmented, composed by epithelial and/or spindle cells with large nuclei and prominent nucleoli, nuclear atypia, and numerous mitotic figures; they commonly showed immunostaining for S-100, HMB 45 and Melan-A. Early detection and surgical resection were the main determinants of survival from this rare malignancy.

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“…A wide range of diagnostic procedures should be performed to exclude primary cutaneous, lymph node or visceral organ affection [ 1 , 2 ]. Except for the ordinary diagnostic procedure with clinical examination, blood tests, biochemistry and imaging diagnosis in order to exclude metastatic spread in melanoma with cutaneous or mucosal origin, a multidisciplinary approach is required to exclude any primary involvement in cases of metastatic disease, including otorhinolaryngological examination; ophthalmological examination, gynecological examination for women and urological for men [ 8 ]. Although imaging diagnostic procedures are also considered helpful, some studies show that although better than CT scan in lymph node staging, the false-positive rate is high in PET-positive lymph nodes measuring less than 1 cm in diameter [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Primary Solitary Melanoma of the Lymphatic Nodes Or a Single Metastasis of Unknown Melanoma: Do We Need a New Staging System?

Tchernev¹,

Chokoeva²,

Popova³

2017

Open Access Maced J Med Sci

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BACKGROUND:Malignant melanoma is a disease which has a cutaneous origin in 90% of the patients, but in rare cases, it could be discovered as secondary deposits with unknown primary site. Metastatic Malignant Melanoma occurs without a primary site in about 3% of all melanoma patients, and it could be divided into two main groups: metastatic lymph nodes’ involvement or non-lymph nodes disease. The lack of unified classification and staging system, provided by AJCC (2009), as well as the lack for curtain diagnostic and therapeutic protocol, prompt us to raise the question what is the right way to precede in cases of metastasis of the lymph nodes, without evidence of a primary tumour?CASE REPORT:We report a case of 67-years- old woman who presented in the dermatology clinic after a surgical removal of an enlarged lymph node in her left femoral area, verified histologically as a metastasis of melanoma. After a diagnostic refinement in the clinic, the diagnosis of metastasis of malignant melanoma was confirmed by histology revision. We use the presented case to create for the first time in the world literature a novel stereotype of thinking, which is also followed by a stereotype of clinical behaviour – gentle to the patient, but providing a certain amount of security and satisfaction for the medical staff.CONCLUSION:The affection of a single lymph node in the absence of a primary tumour should not automatically lead to the conclusion that it is a single metastasis, but rather a primary melanoma of the lymph nodes, in cases of a negative PET scan, for example. In these cases, the measuring of the tumour thickness should guide the further therapeutic behaviour and determine the approach.

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Stage IV malignant melanoma of unknown primary site in a young man

Cited by 4 publications

References 11 publications

Treatment Outcomes for Metastatic Melanoma of Unknown Primary in the New Era: A Single-Institution Study and Review of the Literature

Treatment Outcomes for Metastatic Melanoma of Unknown Primary in the New Era: A Single-Institution Study and Review of the Literature

Primary Melanoma of the Lung: A Systematic Review

Primary Solitary Melanoma of the Lymphatic Nodes Or a Single Metastasis of Unknown Melanoma: Do We Need a New Staging System?

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