共查询到20条相似文献,搜索用时 15 毫秒
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Ooi M Omoto T Ishikawa N Mouri M Okayama T Fukusumi M Ono M Tedoriya T 《Kyobu geka. The Japanese journal of thoracic surgery》2008,61(1):82-85
Primary sarcoma of the pulmonary artery is rare. Diagnosis is difficult and often delayed; pulmonary embolism is part of the differential diagnosis. We treated a 46-year-old woman with progressive dyspnea. Computed tomography showed a lesion occupying the main pulmonary artery and peripheral branches on both sides. The pulmonary artery tumor, resected under cardiopulmonary bypass, was diagnosed pathologically as intimal sarcoma. Two weeks after the operation, the patient was feeling well and discharged from our hospital. Although the prognosis of pulmonary artery sarcoma is poor, early diagnosis and resection may prolong survival. 相似文献
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Primary malignant melanoma of the esophagus: a case report 总被引:1,自引:0,他引:1
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Primary malignant melanoma of the esophagus is an uncommon tumor associated with a poor survival (5% at 5 years), even when resected at an early stage. Because its symptoms are no different from those of other malignant tumors of the esophagus, histopathologic examination is usually needed to reach a definitive diagnosis. A 57-year-old white nonsmoking nonalcoholic woman was referred to our department after 2 months of increasing dysphagia, odynophagia, and weight loss (5 kg in 2 months). Esophagogastroscopy revealed a dark blue, pediculated, polypoid lesion. Biopsies were taken. Endoscopic ultrasound showed a hyperechoic heterogeneous tumor. Barium esophagogram showed a filling defect of ~ 6 cm in the middle-low esophagus, and thoracic and abdominal computed tomography (CT) scan showed a well-delimited esophageal tumor with no clear lymph node enlargement. The pathology report described a proliferation of small spindle-shaped or stellate cells arranged in a spiral or fascicular structure. All tumor cells were intensively positive for immunoreaction, using HMB45 antimelanoma antibodies. To remove the tumor, distal esophagectomy through a double abdominal and thoracic approach was performed. No postoperative complications were reported and no chemo- or radiotherapy was given. The patients is still alive with no evidence of recurrence at 9 months after the operation. 相似文献
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IntroductionMetastatic melanoma of unknown primary (MUP) is an unusual entity found in distant sites without evident skin lesion. We report a case of 45-year-old woman who underwent monobloc resection of a metastatic thoracic malignant melanoma of unknown primary, and who is currently under immunotherapy without local or distant recurrence during a follow-up of 18 months. We demonstrate through this case that R0 resection of an MUP associated with immunotherapy improves the prognosis and survival in these patients.Case reportThis is a 45-year-old woman who underwent monobloc resection of a mass carrying the anterior arch of the second left rib associated with a wedge resection of a nodule at the left upper lobe. Histology confirmed that it was a malignant melanoma. Her history was negative for melanocytic lesions, physical examination and imaging had failed to identify a primary lesion. The patient is currently under nivolumab for Stage IV melanoma and does not present any complications or recurrence during the long term follow up.DiscussionMetastatic melanoma of unknown primary (MUP) is a melanocytic lesion in distant sites in the absence of apparent skin involvement and is rare, accounting for 3, 2% of all incident melanomas as well as being yet poorly understood in terms of pathogenesis (Bae et al., 2015) [1]. MUP is clinically understudied, investigators to date have reported largely on the use of localized treatment for MUP (surgery or radiotherapy), while the efficacy of systemic therapy in MUP patients remains unexplored. Clinical trials of immunotherapy and targeted therapy in patients with advanced cutaneous melanoma have not explicitly reported response rates specific to MUP patient subgroups due to its low incidence and lack of annotation. MUP's response to these now FDA-approved therapies could add to the discussion of MUP's elusive biological characteristics, as well as aid in making clinical recommendations (Utter et al., 2017).ConclusionMetastatic MUP is an extremely rare entity which is still poorly understood, few cases are described in the literature, its treatment remains controversial and there are no specific treatment recommendations for patients with MUP. Several authors recommend local treatment when possible and tend to apply similar strategies for patients with paired stage primary known melanoma (PKM). 相似文献
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Introduction and importanceThe natural history of metastatic melanoma in the absence of a known primary site has been poorly defined. The disease usually presents a significant cause of morbidity and mortality. Around 90% of melanomas have cutaneous origin, but still there are melanomas that could be found in visceral organs or lymph nodes with unknown primary site. Spontaneous regression of the primary site could be an explanation. The disease is frequently diagnosed after treatment for known extracranial metastases and has a poor outcome despite various local and systemic therapeutic approaches.Case presentationHerein, we present a case of a 43-year old female presented with history of headaches and enlarged a left inguinal lymph node. Notably, no cutaneous lesions could be identified by history or on physical examination. CT-scan of the brain revealed a space occupying lesion and the inguinal lymph node biopsy confirmed the diagnosis of metastatic malignant melanoma. The patient succumbed shortly after establishment of diagnosis.Clinical discussionMost patients with brain metastases from malignant melanoma are diagnosed after treatment for known extracranial metastases and have a poor outcome despite various local and systemic therapeutic approaches.ConclusionMetastatic melanomas of brain with unknown primary present a significant morbidity and mortality and confer a poor prognosis. Delay in diagnosis and treatment is of serious concern when it comes to improve the prognosis of patients with this disease. The optimal treatment depends on the objective situation, often surgery, radiosurgery, whole brain radiotherapy and chemotherapy can be used in combination to obtain longer remissions and optimal symptom relieve. 相似文献
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Y Yamashita T Hirai H Mukaida K Kawano T Toge M Niimoto T Hattori T Kunita 《The Japanese journal of surgery》1989,19(4):498-501
An unusual case of primary esophageal melanoma is reported herein. A 68 year old man who had experienced occasional dysphagia for about one month without suffering any weight loss was admitted to our department. An esophagogram revealed two lobulated masses and esophagoscopy showed a pigmented tumor in one of the masses. Curative surgery was thus performed through a right thoracotomy. The macroscopic appearance of the resected specimen was very unusual and it was subsequently proven to be primary malignant melanoma of the esophagus by histological examination. Postoperatively, cyclophosphamide and interleukin-2 were administered intravenously, followed by lymphokine-activated killer therapy. However, multiple liver metastases were found on a CT scan, 3 months after the operation and he died about 1 month later. The operative indications for primary malignant melanoma of the esophagus are discussed in this report. 相似文献
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We report a case of primary malignant melanoma (MM) of the stomach. The patient, a 73-year-old man, was referred to our hospital
for investigation of an elevated lesion in the stomach, detected by gastroscopy. On admission, physical examinations and laboratory
data were unremarkable. Gastroscopy revealed a pigmented, elevated tumor, approximately 2 cm in diameter, in the posterior
wall of the stomach. A biopsy was taken, which resulted in a diagnosis of MM, based on the presence of melanin in tumor cells.
F-18 fluorodeoxyglucose positron emission tomography showed no accumulation of tracer except for the tumor in the stomach,
indicating that it was a primary MM of the stomach. The patient underwent distal gastrectomy, but died of recurrence 1 year
later. Very few cases of primary MM of the stomach have been reported. Thus, we report this case, followed by a review of
the literature. 相似文献
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Inoue M Ishioka J Kageyama Y Fukuda H Higashi Y 《Hinyokika kiyo. Acta urologica Japonica》2008,54(4):305-308
A 70-year-old man presented with hematuria and urodynia. A hemorrhagic black tumor and surrounding tan-colored flat lesions were observed at the distal urethra on urethroscopy. Atypical cells consistent with malignant melanoma were noted in urinary cytologic samples. Total penectomy and prostatectomy were performed with negative surgical margin. Because of negative sentinel biopsy of inguinal lymph nodes, further lymph nodes exploration was omitted. However, recurrent tumors at the perineal region and metastases to pelvic lymph nodes appeared four months after surgery, and he died eleven months later. 相似文献
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H Kajikawa M Takada T Seguchi H Sakaguchi 《Hinyokika kiyo. Acta urologica Japonica》1987,33(1):97-100
A 76-year-old woman visited us with the chief complaint of a urethral mass on September 11, 1984. There was a thumb-sized, brownish and painless mass in the posterior wall of the urethra. Although excretory urogram revealed nothing remarkable, CT scan suggested metastasis of retroperitoneal lymph nodes. Biopsy of the urethral mass revealed malignant melanoma. She was treated with combined chemotherapy of dimethyltriazenoimidazole carboxamide, peplomycin, and cis-diamine-dichloride platinum, but died of respiratory insufficiency on January 6, 1985. Thirteen cases of primary malignant melanoma of the female urethra, including our own, have been reported in the Japanese literature. 相似文献
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Mukai M Uemura M Fukuhara S Kanno N Nishimura K Miyoshi S Yoshida K Kawano K 《Hinyokika kiyo. Acta urologica Japonica》2003,49(3):157-160
A 72-year-old female with a complaint of hemorrhagic leucorrhea was referred to our department. She had a black tumor on her urethral meatus suspected as a malignant melanoma. Urethrectomy, vulvectomy, partial vaginectomy, bilateral inguinal lymphadenectomy, and cystostomy were performed. Pathological diagnosis was malignant melanoma of the urethra. Local recurrence and lymph node metastasis were found 9 months later, and she has been given DAV-feron combined therapy. 相似文献
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A 77-year-old male was admitted to our department with the chief complaint of positive occult blood in urine on July 30, 1984. Endoscopically, we found a dark red tumor on the left posterior wall of the urinary bladder, which seemed to have coagula covering it. On August 31, transurethral resection of the bladder tumor (TUR-Bt) was performed, and the pathological interpretation was malignant melanoma. Dermatologically and ophthalmologically, we could not found the primary foci. A month later, cystoscopy demonstrated multiple blue black spots consistent with diffuse melanoma of the bladder. On May 7, 1985, he was admitted to our clinic with right hypochondralgia. On physical examination, the liver was palpable with an irregular surface, and the echogram showed multiple metastasis in the liver. TUR-Bt was carried out again, on May 17, 1985. Ultrastructually resected specimens demonstrated a lot of mature melanosomes in the tumor cells. The course of the patient progressively worsened, and he died on May 30, 1985. At autopsy, we found metastases in the central nervous system, bone, genitourinary tract, gastrointestinal tract and other organs. The left eye ball, which had been diagnosed as ophthalmomalacia by glaucoma six years earlier, was filled by a melanoma mass, and it seemed to be the primary foci. 相似文献
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A case of primary anorectal malignant melanoma in a 66-year-old lady is presented and the clinical, radiological and surgical features reviewed. The presenting symptoms similar to the more commonly encountered haemorrhoids led to a delay in the eventual diagnosis and treatment, resulting in limited post-operative survival. The relevant literature is reviewed and an emphasis made on the accurate histological diagnosis of anorectal growths. 相似文献
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Primary spinal intramedullary malignant melanoma: case report 总被引:1,自引:0,他引:1
A rare case of primary spinal intramedullary malignant melanoma at the T6 level in a 31-year-old man is presented. The tumor was partially removed, and neuroaxis irradiation up to 50 Gy was then administered. Subsequently, systemic interferon beta (specific activity, 2.0 X 10(8) IU/mg protein) therapy (total dose, 2.2 X 10(7) units) was begun. At the completion of these therapies, immunohistochemical analysis with monoclonal antibodies against melanoma-associated antigens confirmed the presence of melanoma cells in the cerebrospinal fluid (CSF). Chemotherapy with intrathecal administration of dacarbazine (dimethyltriazenoimidazole carboxamide, DTIC) was then initiated, to avoid the dissemination of tumor cells by the CSF. Periodic cytological examination of CSF for melanoma cells revealed a marked reduction in the number of tumor cells. Pharmacokinetic study showed that the disappearance of DTIC from the CSF was biphasic, with an initial half-life of 30 minutes and a terminal half-life of 5 hours. Follow-up examination by MRI 1 year after the operation did not disclose any significant increase in size of the residual tumor. Neither recurrence nor metastasis was observed. The pertinent literature on spinal cord melanoma is reviewed, and the usefulness of MRI and intrathecal chemotherapy with DTIC is discussed. 相似文献