scholarly journals Multifocal BRAFV600E-Mutated Melanoma in situ on the Foot

2015 ◽  
Vol 7 (3) ◽  
pp. 322-327
Author(s):  
Eimei Iwama ◽  
Taku Fujimura ◽  
Yoshiyuki Kusakari ◽  
Takahiro Haga ◽  
Setsuya Aiba
Keyword(s):  
Skin Cancer ◽  
Clinical Features ◽  
Braf Mutation ◽  
Spontaneous Regression ◽  
Normal Skin ◽  
Brafv600e Mutation ◽  
Braf Gene ◽  
Melanoma In Situ ◽  
Pigmented Lesions

Melanoma is an aggressive skin cancer that originates from melanocytes, and about one half of melanoma cases possess a BRAF mutation. Together with PD-L1 expression, the BRAFV600E mutation is one of the optimal therapeutic targets for the treatment of melanoma. In this report, we describe a case of multifocal melanoma in situ on the foot, which carried the p.V600E mutation in the BRAF gene. Interestingly, the spotted melanoma lesion is demarcated by normal skin, and in all spotted pigmented lesions, there were no signs of dermal invasion of melanoma cells or spontaneous regression. Our case presented atypical clinical features, which might correlate with the local mutations of BRAF gene and the immunological expression of PD-L1.

Recurrent primary vulvovaginal malignant melanoma arising in melanoma in situ – the natural history of lesions followed for 23 years

2004 ◽  
Vol 14 (4) ◽  
pp. 628-632
Author(s):  
N. J. Kingston ◽  
R. W. Jones ◽  
J. Baranyai
Keyword(s):  
Malignant Melanoma ◽  
Natural History ◽  
Metastatic Melanoma ◽  
Cutaneous Melanoma ◽  
Mucosal Melanoma ◽  
Histologic Examination ◽  
Melanoma In Situ ◽  
Pigmented Lesions ◽  
History Of

Multifocal melanoma and melanoma in situ of the vulva and vagina are uncommon lesions, and our understanding of their natural history is limited. Vulvovaginal melanoma appears to be biologically different from cutaneous melanoma and has more in common with mucosal melanoma. A 60-year-old woman presented in 1977 with a pigmented vulvar lesion. Histologic examination revealed melanoma in situ associated with focal invasive melanoma. She re-presented with recurrent primary melanomas arising in melanoma in situ in 1990 and 1998 and died of widespread metastatic melanoma in 2000. Melanoma in situ of the vulva and vagina is rare and appears to have a relatively slow but definite progression to invasive melanoma. All suspicious pigmented lesions in this region should be biopsied, and if multifocal in situ melanoma is identified, vulvo(vagin)ectomy should be considered.

scholarly journals Multiple melanoma in a burns scar

2018 ◽  
Vol 11 (1) ◽  
pp. e227295 ◽  
Author(s):  
Phillip Cantwell ◽  
Adrian Brooks
Keyword(s):  
Case Report ◽  
Breslow Thickness ◽  
Malignant Tumours ◽  
Burn Scar ◽  
Melanoma In Situ ◽  
Pigmented Lesions ◽  
Digital Amputation ◽  
Little Finger

It is well known that up to 2% of chronic burn scar lesions can transform into malignant tumours, however, melanoma formation at these sites is extremely rare. This case report describes a burns case, which progressed to four melanomas in a 78-year-old male patient’s little finger, 40 years after the initial incident. The patient underwent 3 mm punch biopsies, then digital amputation of the finger with pathology-proven melanoma. Histopathology investigation demonstrated three melanoma in situ and one invasive melanoma with a Breslow thickness of 1 mm. These findings are rare with few reports of melanoma in burn scars in the literature. This case report highlights the vigilance required from clinicians when performing skin examinations, and the importance of biopsies to newly pigmented lesions.

scholarly journals Treatment of recurrent mucosal melanoma of the oral cavity with topical imiquimod and pembrolizumab achieves complete histopathologic remission

2021 ◽  
Vol 9 (10) ◽  
pp. e001219
Author(s):  
Tejus Satish ◽  
Shaheer Khan ◽  
Matt Levin ◽  
Richard Carvajal ◽  
Angela J Yoon
Keyword(s):  
Malignant Melanoma ◽  
Hard Palate ◽  
Mucosal Melanoma ◽  
Topical Imiquimod ◽  
Melanoma In Situ ◽  
Oral Melanoma ◽  
Pigmented Lesions ◽  
Adjuvant Temozolomide ◽  
Oral Mucosal Melanoma

Mucosal melanomas constitute a subtype of melanoma with less effective treatments than cutaneous melanomas. We present a case of oral mucosal melanoma that recurred despite multiple resections and adjuvant temozolomide. Treatment with topical imiquimod combined with pembrolizumab achieved remission. A 56-year-old woman presented with a pigmented mass on her left anterior hard palate. Biopsy revealed malignant melanoma. The patient had resection with neck dissection with 3 months of adjuvant temozolomide due to positive margins. Malignant melanoma involving the hard palate recurred 1 year later requiring additional resection. Two years later, two additional pigmented lesions were found; further resections were deferred due to expected morbidity. Following 6 weeks of topical imiquimod treatment, the lesions shrunk significantly. Adjuvant pembrolizumab was added and complete histopathologic remission was observed in 6 months. The patient remained in remission for 4 years before new melanoma in situ was diagnosed, requiring five additional months of imiquimod. As of April 2021, there is no clinical evidence of melanoma. There are limited reports of oral melanoma treated with topical imiquimod. Here, imiquimod administered in combination with pembrolizumab achieved complete pathologic response.

scholarly journals Micromelanomas: A Review of Melanomas≤2 mm and a Case Report

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Sharad P. Paul
Keyword(s):  
Case Report ◽  
Previous History ◽  
Melanoma In Situ ◽  
Pigmented Lesions ◽  
Pigmented Lesion ◽  
History Of

The ABCD acronym used to screen pigmented lesions for melanoma obviously was not designed to contend with melanomas that are under 2 mm in diameter. Previously, views ranged that such small lesions could not be melanomas until a few reports of such “micromelanomas” emerged. The author presents a 2 mm melanoma in situ presenting as an insignificant pigmented lesion in a 60-year-old patient with no previous history of melanoma or multiple nevi—which is usually the norm in cases of small melanoma. This paper reiterates the fact that when it comes to a melanoma, size does not matter. In this paper, the term “micromelanoma” is used by the author to represent melanomas under 2 mm. Dermatoscopy and histopathology findings are discussed in this case, along with a review of small melanomas.

scholarly journals Melanoma Arising after Imiquimod Use

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Sharad P. Paul
Keyword(s):  
Skin Cancer ◽  
De Novo ◽  
Precancerous Lesions ◽  
Antiviral Agents ◽  
Cutaneous Metastases ◽  
First Line Therapy ◽  
Melanoma In Situ ◽  
Skin Cancers

Imiquimod belongs to the class of 1H-imidazo-[4,5-c]quinolones—drugs originally developed as nucleoside analogues with the aim of finding new potential antiviral agents (Harrison et al., 1988). Indeed, Imiquimod was first released as treatment for genital warts before its actions against skin cancer were studied. Imiquimod is a relatively small sized molecule (Mr = 240.3) and is hydrophobic, allowing it to penetrate the skin epidermal barrier and therefore making it suitable for topical formulations (Gerster et al., 2005). Imiquimod has shown itself effective against skin cancers and precancerous lesions, especially basal cell cancers and actinic keratosis (Salasche et al., 2002, Beutner et al., 1999). There have been reports of Imiquimod being used as topical treatment against cutaneous metastases of melanoma and some authors have reported its use as first-line therapy against melanoma in situ (Smyth et al., 2011, Gagnon, 2011). We report a case of an invasive malignant melanoma arising de novo at the specific site of application of Imiquimod (Aldara cream 5%) for a biopsy-proven superficial BCC. Therefore while Imiquimod has added to our topical armamentarium against skin cancer, care must be exercised in prescribing this treatment and it is especially important to follow up patients regularly.

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