Sudden Death from Primary Cerebral Melanoma: Clinical Signs and Pathological Observations

Maiellaro, Alfonso; Perna, A; Giugliano, Pasquale; Esposito, Massimiliano; Vacchiano, Giuseppe

doi:10.3390/healthcare9030341

Cited by 4 publications

(3 citation statements)

References 71 publications

(29 reference statements)

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“…14,56 This is particularly essential if the cause of donor death is due to intracerebral hemorrhage because there is a possibility of missed diagnosis of melanomas as in Buell et al 27 and Stefankov a et al 30 Several reports mention melanoma developing in numerous organ recipients from donors who died of intracerebral hemorrhage with no history of melanoma. 57,58 One cause of intracerebral hemorrhage is cerebral melanoma, 59 hence a possible explanation for these could be that cerebral melanoma in those donors were transmitted to the recipients. There have been some advances with utilizing medical imaging and serology to investigate for malignancy in donors; however, there remains a role for autopsy to detect melanoma.…”

Section: Discussionmentioning

confidence: 99%

Outcomes in organ transplants from donors with melanoma: a systematic review

Curchin

McGinn

et al. 2023

Int J Dermatology

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Melanoma transmitted through organ transplantation is an increasingly reported event. Immunosuppression increases the risk of melanoma; however, transmission of malignancy from transplanted organs is a distinct etiology of melanoma occurrence. The risk of transmission of melanoma from an organ donor with melanoma has yet to be determined. The authors aimed to investigate this phenomenon by reviewing the outcomes of patients that received organs from donors with melanoma. A systematic literature review was conducted with emphasis on identifying organ donors with known histories of melanoma and reported information regarding recipients of their organs. The databases PubMed, MEDLINE, Embase, and JBI EBP were searched in January 2023. Search terms included “melanoma,” terms for solid organs, “donor,” “transplant,” “transmission,” and their variations as well as terms related to temporal relations. Inclusion criteria were articles that stated outcomes in organ recipients from donors that had a diagnosis of melanoma either pretransplant or postmortem. Reference lists of selected articles were hand searched for further studies. A total of 232 articles were identified from the search parameters. After applying inclusion and exclusion criteria, 13 articles were selected. Hand searching the references of these articles yielded four additional articles. Of the 75 organ recipients that received organs from donors with known melanoma, 43 developed melanoma. While a definitive quantitative risk cannot be ascertained based on our review, the numerous reported cases of melanoma in organ recipients from donors that have melanoma should still be considered by clinicians.

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Section: Discussionmentioning

confidence: 99%

Outcomes in organ transplants from donors with melanoma: a systematic review

Curchin

McGinn

et al. 2023

Int J Dermatology

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“…It was a useful tool, which should be applied to the routine autopsy protocol [ 32 , 33 , 34 ]. Autopsy plays a crucial role in identifying the cause of death beyond any doubt [ 35 , 36 , 37 , 38 , 39 ]. Many unexpected deaths are currently associated with cardiovascular diseases and in many cases without any type of confirmation.…”

Section: Discussionmentioning

confidence: 99%

Multidisciplinary Approach to Suspected Sudden Death Caused by Arteriovenous Malformation Rupture: A Case Report

et al. 2021

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Arteriovenous malformations (AVMs) are rare congenital conditions with a prevalence of less than 1% and are mostly asymptomatic. However, these malformations can suddenly cause intense pain or bleeding, leading to life-threatening medical problems. This report presents a case of an unexpected death in a 37-year-old previously healthy woman due to an intra-cerebellum arteriovenous malformation rupture identified during autopsy. While infective processes where preliminarily excluded, a Post Mortem Computed Tomography (PMCT) identified a tetra ventricular hemorrhage and intra-cerebellum hemorrhage. Toxicological examination was negative for most substances of abuse. During autopsy an intense hemorrhagic infiltrate in the subarachnoid space was observed. After formalin fixation of the brain the cerebellum showed hemorrhagic infarction on fourth ventricle sides, as well as several small reddish infarctions across the entire cerebellum parenchyma. Histological examination of the brain and cerebellum showed a suffusion of erythrocytes in the sub-arachnoid region. Evidence of an arterio-venous malformation, with several intertwine vessels of variable diameter, surrounded by hemorrhagic evidence. The autopsy played a crucial role in identifying the location and the possibly affected vessel, as well as defining the cause of death. It is necessary to have a greater number of autopsies to make an epidemiological contribution. Furthermore, it is crucial to create a multicenter data network with other authors from other departments to improve information about epidemiological, clinical, diagnostic and therapeutic data. Most brain AVMs as cause of death are often undiscovered.

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“…Forensic science is a multidisciplinary science that uses the principles of different fields, such as chemistry, physics, and biology, in order to supply the so-called "weight of evidence" [1][2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Pharmacogenetics and Forensic Toxicology: A New Step towards a Multidisciplinary Approach

Nunno

Esposito

Argo

et al. 2021

Toxics

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Pharmacogenetics analyzes the individual behavior of DNA genes after the administration of a drug. Pharmacogenetic research has been implemented in recent years thanks to the improvement in genome sequencing techniques and molecular genetics. In addition to medical purposes, pharmacogenetics can constitute an important tool for clarifying the interpretation of toxicological data in post-mortem examinations, sometimes crucial for determining the cause and modality of death. The purpose of this systematic literature review is not only to raise awareness among the forensic community concerning pharmacogenetics, but also to provide a workflow for forensic toxicologists to follow in cases of unknown causes of death related to drug use/abuse. The scientific community is called on to work hard in order to supply evidence in forensic practice, demonstrating that this investigation could become an essential tool both in civil and forensic contexts. The following keywords were used for the search engine: (pharmacogenetics) AND (forensic toxicology); (pharmacogenetics) AND (post-mortem); (pharmacogenetics) AND (forensic science); and (pharmacogenetics) AND (autopsy). A total of 125 articles were collected. Of these, 29 articles were included in this systematic review. A total of 75% of the included studies were original articles (n = 21) and 25% were case reports (n = 7). A total of 78% (n = 22) of the studies involved deceased people for whom a complete autopsy was performed, while 22% (n = 6) involved people in good health who were given a drug with a subsequent pharmacogenetic study. The most studied drugs were opioids (codeine, morphine, and methadone), followed by antidepressants (tricyclic antidepressants and venlafaxine). Furthermore, all studies highlighted the importance of a pharmacogenetics study in drug-related deaths, especially in cases of non-overdose of drugs of abuse. This study highlights the importance of forensic pharmacogenetics, a field of toxicology still not fully understood, which is of great help in cases of sudden death, deaths from overdose, deaths after the administration of a drug, and also in cases of complaint of medical malpractice.

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Sudden Death from Primary Cerebral Melanoma: Clinical Signs and Pathological Observations

Cited by 4 publications

References 71 publications

Outcomes in organ transplants from donors with melanoma: a systematic review

Outcomes in organ transplants from donors with melanoma: a systematic review

Multidisciplinary Approach to Suspected Sudden Death Caused by Arteriovenous Malformation Rupture: A Case Report

Pharmacogenetics and Forensic Toxicology: A New Step towards a Multidisciplinary Approach

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