Localized primary melanoma of male urethra with a 4-year follow up

Most of melanomas of the gallbladder are metastatic lesions of cutaneous melanoma. Primary melanomas of the gallbladder are described as single, polypoid, intraluminal masses emanating from the mucous membrane. The most important characteristic is the absence of melanoma damage to the skin. If it is not possible to localize primary melanoma a multidisciplinary approach to diagnostic search comes to the fore. Predicting for primary melanoma of the gallbladder is a difficult task due to the small number of cases and the absence of long-term follow-up for this category of patients.

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NCMP-03. ANATOMIC AND SURGICAL FACTORS PREDICT DEVELOPMENT OF LEPTOMENINGEAL DISEASE IN PATIENTS WITH METASTATIC MELANOMA

Neuro-Oncology ◽

10.1093/neuonc/noab196.576 ◽

2021 ◽

Vol 23 (Supplement_6) ◽

pp. vi147-vi147

Author(s):

Stephen Lowe ◽

Christopher Wang ◽

Amanda Brisco ◽

John Arrington ◽

Kamran Ahmed ◽

...

Keyword(s):

Brain Metastases ◽

Primary Melanoma ◽

Female Gender ◽

Causative Factor ◽

Leptomeningeal Disease ◽

Melanoma Brain Metastases ◽

Highly Correlated ◽

Periventricular Lesions ◽

Dural Metastasis

Abstract Leptomeningeal disease (LMD) is a devastating complication of systemic malignancy, portending a poor prognosis with an estimated median survival of 4-6 weeks if left untreated. Several reports have suggested surgical resection as a potential causative factor. Herein, we explore if surgical and anatomical factors are correlated with development of LMD in patients with melanoma brain metastases. METHODS: Patients treated at our institution between 1999-2019 for primary melanoma with brain metastasis were compiled into a database based on ICD9/10 coding. 1,079 patients with melanoma brain metastases and appropriate imaging were identified, and 834 patients with a minimum of 3 months’ follow up were included. Patients were dichotomized by development of LMD or lack thereof, and categorized into an overall cohort, and surgical and non-surgical cohorts. Anatomic factors and ventricular access during surgery were investigated as possible correlative factors for the development of LMD. RESULTS: In the overall cohort, female gender(p=0.033), presence of dural metastasis(p=0.018), presence of periventricular lesions(p< .001), presence of intraventricular lesions(p< .001), and ventricular access during surgery(p< .001) were significantly associated with LMD. Patients undergoing surgery, or those undergoing surgery without ventricular access, were not at higher risk of LMD. On multivariate analysis, female gender(p=.033), presence of periventricular lesions (p< .001), presence of intraventricular lesions(p< .002), and presence of dural metastasis(p=0.032) were significantly associated with development of LMD. In patients who had surgery, iatrogenic ventricular access(p< .001) was significantly correlated with LMD. In the group of patients without surgery, those with periventricular lesions had significantly higher odds of LMD(p< .001). CONCLUSIONS: In a retrospective cohort of patients with melanoma metastatic to the brain, surgical intervention does not increase odds of LMD; however, iatrogenic access to the CSF space during surgery is highly correlated with LMD development. Anatomic contact with the CSF space predicts LMD regardless of surgical status.

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Second Primary Melanomas: Incidence and Outcome

The American Surgeon ◽

10.1177/000313481007600718 ◽

2010 ◽

Vol 76 (7) ◽

pp. 675-681 ◽

Cited By ~ 13

Author(s):

Matthew R. Bower ◽

Charles R. Scoggins ◽

Robert C. G. Martin ◽

Michael P. Mays ◽

Michael J. Edwards ◽

...

Keyword(s):

Early Stage ◽

Primary Melanoma ◽

Disease Free Survival ◽

Second Primary ◽

Free Survival ◽

Kaplan Meier ◽

Ongoing Surveillance ◽

Post Hoc ◽

Disease Free

The objective of this study was to determine the incidence of multiple primary melanomas (MPM) and other cancers types among patients with melanoma. Factors associated with development of MPM were assessed in a post hoc analysis of the database from a multi-institutional prospective randomized trial of patients with melanoma aged 18 to 70 years with Breslow thickness 1 mm or greater. Disease-free survival (DFS) and overall survival (OS) were evaluated by Kaplan-Meier analysis. Forty-eight (1.9%) of 2506 patients with melanoma developed additional primary melanomas. Median follow-up was 66 months. Except in one patient, the subsequent melanomas were thinner (median, 0.32 mm vs 1.50 mm; P < 0.0001). Compared with patients without MPM, patients with MPM were more likely to be older (median age, 54.5 vs 51.0 years; P = 0.048), to have superficially spreading melanomas (SSM) ( P = 0.025), to have negative sentinel lymph nodes ( P = 0.021), or to lack lymphovascular invasion (LVI) ( P = 0.008) with the initial tumor. On multivariate analysis, age ( P = 0.028), LVI ( P = 0.010), and SSM subtype of the original melanoma ( P = 0.024) were associated with MPM. Patients with MPM and patients with single primary melanoma had similar DFS (5-year DFS 88.7 vs 81.3%, P = 0.380), but patients with MPM had better OS (5-year OS 95.3 vs 80.0%, P = 0.005). Nonmelanoma malignancies occurred in 152 patients (6.1%). Ongoing surveillance of patients with melanoma is important given that a significant number will develop additional melanoma and nonmelanoma tumors. With close follow-up, second primary melanomas are usually detected at an early stage.

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Second Primary Melanoma: Risk Factors, Histopathologic Features, Survival, and Implications for Follow-Up

The American Surgeon ◽

10.1177/000313481608201034 ◽

2016 ◽

Vol 82 (10) ◽

pp. 1009-1013 ◽

Cited By ~ 8

Author(s):

Maris S. Jones ◽

Hitoe Torisu-Itakura ◽

Devin C. Flaherty ◽

Hans F. Schoellhammer ◽

Jihey Lee ◽

...

Keyword(s):

Risk Factors ◽

High Risk ◽

Cutaneous Melanoma ◽

Primary Melanoma ◽

Second Primary ◽

Melanoma Risk ◽

Impact On Survival ◽

The Impact ◽

Histopathologic Features

The impact on survival of a second primary melanoma (SPM) is unclear. We used our melanoma center's database to examine clinicopathologic risk factors and outcomes of stage 0 to IV cutaneous melanoma in patients with one versus two primaries. Among 12,325 patients with primary melanoma, 969 (7.86%) developed SPM. SPMs were significantly thinner than autologous primary melanomas ( P = 0.01), and 451 SPM patients had better overall and melanoma-specific survival than 451 prognostically matched non-SPM patients ( P < 0.0001 and 0.0001, respectively) at a median follow-up of 142.37 months. Patients with cutaneous melanoma are at high risk for development of SPM, but the development of SPM does not seem to impair survival.

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Primary melanoma of the male urethra

Türk Üroloji Dergisi/Turkish Journal of Urology ◽

10.5152/tud.2013.041 ◽

2014 ◽

Vol 39 (3) ◽

pp. 201-203 ◽

Cited By ~ 2

Author(s):

Hatice Karaman ◽

Yuksel Yesil

Keyword(s):

Primary Melanoma ◽

Male Urethra

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Multiple primary melanoma: the impact of atypical naevi and follow up

British Journal of Dermatology ◽

10.1111/j.1365-2133.2010.09961.x ◽

2010 ◽

Vol 163 (6) ◽

pp. 1319-1322 ◽

Cited By ~ 20

Author(s):

V. De Giorgi ◽

S. Rossari ◽

F. Papi ◽

A. Gori ◽

B. Alfaioli ◽

...

Keyword(s):

Primary Melanoma ◽

Multiple Primary ◽

The Impact

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Multiple primary melanomas detected after long-term follow-up for the first primary melanoma : A case report

Skin Cancer ◽

10.5227/skincancer.30.223 ◽

2015 ◽

Vol 30 (3) ◽

pp. 223-227

Author(s):

Kentaro ONO ◽

Hiroshi FURUKAWA ◽

Toshihiko HAYASHI ◽

Yuhei YAMAMOTO

Keyword(s):

Case Report ◽

Primary Melanoma ◽

Multiple Primary ◽

Long Term Follow Up

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Second primary melanoma: Risk factors, histopathologic features, and survival

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.9073 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 9073-9073

Author(s):

H. F. Schoellhammer ◽

H. Torisu-Itakura ◽

Y. Huynh ◽

M. Sim ◽

M. B. Faries ◽

...

Keyword(s):

Primary Melanoma ◽

Breslow Thickness ◽

Second Primary ◽

Clark Level ◽

Ajcc Stage ◽

Melanoma Patients ◽

Level I ◽

Second Primaries

9073 Background: Melanoma incidence in the United States is expected to be 4.3% of all cancers in 2008. Cutaneous melanoma patients are at risk for second primary melanoma development. Our goal was to characterize the histopathologic features, risk factors, and patient survival for second primary melanoma. Methods: A review of the melanoma database established in 1971 at John Wayne Cancer Institute was conducted identifying patients with American Joint Committee on Cancer (AJCC) stage I and II cutaneous melanoma who later developed a second primary melanoma. Patients were grouped by Breslow thickness, Clark level, and histopathologic subtype (superficial spreading [SSM], nodular, acral lentiginous, lentigo maligna, and in situ). Multivariate analysis involving age, gender, Breslow thickness, Clark level, and ulceration status was performed to determine an effect on development of second primary. Kaplan-Meier survival curves were plotted for single primary and second primary melanoma patients. Results: Second primary melanoma was identified in 411 (3.7%) of 10,968 patients with AJCC stage I-II melanoma. The most common first primary subtype was SSM, and 93% of these patients had in situ or SSM as the second primary. Sixty-five percent of first primaries had a Breslow thickness of ≤1 mm, and 75% of second primaries had a thickness ≤1 mm. Forty-nine percent of first primaries had Clark level I or II, but 68% of second primaries had Clark level I or II. In multivariate analysis, only increasing age was significantly associated with the likelihood of second primary melanoma (p<0.0001). With increasing follow-up time the hazard ratio of second primary melanoma was 1.31 for every decade. Overall survival for second primary melanoma patients was better than for single primary patients (p<0.0001). Conclusions: Most second primary melanoma patients will have SSM or in situ, with a decreased Clark level and Breslow thickness. Contrary to expectations, patients developing second primary melanoma did not exhibit decreased overall survival. Increased follow-up time after first primary melanoma is a significant risk factor for second primary development, thus illustrating the importance of lifelong patient follow-up. No significant financial relationships to disclose.

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Characterizing the tumor microenvironment (TME) in primary melanomas using multiplex immunohistochemistry (mIHC).

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.9580 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 9580-9580

Author(s):

Robyn Denise Gartrell ◽

Douglas Kanter Marks ◽

Thomas Hart ◽

Edward Stack ◽

Yan Lu ◽

...

Keyword(s):

Spatial Analysis ◽

Immune Cell ◽

Medical Center ◽

Primary Melanoma ◽

Columbia University ◽

Ki67 Expression ◽

Hla Dr ◽

Immune Cell Subsets ◽

Low Levels

9580 Background: Biomarkers are needed in primary melanoma to risk stratify for adjuvant trials. High levels of infiltrating cytotoxic (CD8+) T lymphocytes (CTLs) and low levels of CD68+ macrophages (MΦ) may correlate with prolonged survival but quantification methods are not standardized for clinical practice. HLA-DR is a marker of MΦ activation not expressed by suppressor myeloid cells. A novel pathology technique using mIHC allows for quantitative and spatial analysis of immune cell subsets. Methods: In a pilot set of stage II/III primary melanomas from Columbia University Medical Center (n = 94), clinical follow up is available for 51 cases. 32 had no evidence of recurrence at last follow up (minimum 2 years) while 19 died of melanoma. 5µm slides were stained using Opal multiplexed IHC (mIHC) for DAPI, CD3, CD8, CD68, SOX10, HLA-DR and Ki67. Tumor areas were pre-selected by a dermatopathologist, visualized using Mantra (Perkin Elmer) and analyzed using inForm (Perkin Elmer) and Spotfire (TIBCO). Results: In all patients (n = 94), CTLs are farther from tumor (SOX10+) cells when they are proliferating (Ki67+) (p < 0.0001***), while they are closer to MΦ when they are activated (HLA-DR+) (p = 0.0002***). Next, we evaluated impact on prognosis using disease specific survival (DSS) as an outcome based on median value (n = 51). In this exploratory study no correction for multiple comparisons was made. We find that CTL density correlates with prolonged DSS in tumor (p = 0.0185*) but not in stroma (p = 0.1630 ns). Ratio of density of CD8/CD68+HLA-DR- correlates with DSS in both tumor (p = 0.027*) and stroma (p = 0.017*). Finally, distance from CTLs to HLA-DR- MΦ was significantly greater in non-recurrent melanomas as compared to recurrent ones (p = 0.0167*). Conclusions: HLA-DR expression on MΦ and Ki67 expression on tumor cells correlate with position of CTLs in TME in primary melanoma. CTL density is a favorable prognostic marker while HLA-DR non-expressing MΦ may favor tumor progression. Quantitative mIHC allows for accurate spatial analysis of immune subsets within the TME and the development of novel, more accurate and potentially clinically relevant biomarkers.

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