Assessment of 35 Years Longitudinal Observations on Melanoma Patients in a Single Center of Hungary’s Central Region: Effect of Interferon Immunotherapy

Background: The incidence of melanoma malignum increases worldwide. Detailed objective analyses from central European region are scarcely available. Objective: To obtain validated data on melanoma distribution and retrospective analysis in the central region of Hungary based on 35 years of experience in a single center. Methods: The authors monitored the clinical course of their patients with melanoma between 1984 and 2018 based on the digitalized documentation of their institute. They analyzed the treated and non-treated cases with the leadership of a dermatologist-pathologist-oncologist. Altogether 867 cases (450 female, 417 male) were examined from the removal of the primary tumor onwards in retrospective way. Results: Distribution of gender, age, tumor stages and body regions by genders were examined. The authors also reviewed the asymptomatic period until tumor progression, morbidity data, the period and effect of the adjuvant low, intermediate and high dose interferon α-2b immunotherapy. Patients with lymph node metastasis who received low or intermediate dose immunotherapy experienced significantly longer tumor-free period than those who got high-dose immunotherapy. In both treated groups, the median value of the asymptomatic months was higher compared to the observation only” group. Conclusion: The results of their long-term follow-up contribute to the accurate evaluation of melanoma and of the interferon therapy in Hungary and in the region.

Metastatic disease of melanoma malignum choroid

Introduction. Choroidal melanoma is a rare form of cancer, with a total of 3-5% of the patients suffering from this type of disease. People who are more likely to suffer from the disease are of the white race, bright skin color and iris, as well as those with a genetic mutation BAP 1 and GNAQ. Studies indicate the micro-metastatic disease before the primary process is diagnosed. There is no effective therapy to prevent the development of metastases. In 90% of cases the metastases are in the liver. Metastases can occur any time after the diagnosis of melanoma, even after 40 years. The prognosis of metastatic disease is bad, the median of survival per year is 4 to 15 months. Case report. The patient had enucleation of the eye, when he was primarily treated for malignant melanoma of choroid in 2007. He also appeared regularly for checkups. Felt healthy. 9 years later, dizziness and instability occurred. After a seizure, on July 2016, echotomography and computed tomography diagnosed liver, brain metastases as well as changes in the right lung. Radio-oncology treatment deposits in the brain done with Gama knife, as well as systemic hemotherapy with Dacarbazine. Changes in the lung treated as a secondary deposit. Despite oncology and palliative treatment, the patient passed away 6 months after the diagnosis of the metastatic disease. Conclusion. It is important to point out the importance of early and accurate diagnosis and early treatment of malignant diseases. During the period of monitoring the patient, rare localizations of the metastases must be considered, as well as the possibility of their occurrence long time after the discovery of the primary malignancy. For this case report, the data obtained from extensive medical documentation was used, as well as several years of monitoring patients in Primary care.

Antiproliferative and proapoptotic activity of ursolic acid in human skin malignant melanoma cells

Aim: Pentacyclic triterpenoid – ursolic acid is one of the most promising anticancer agents of biological origin. Especially modulation of cellular signalling pathways (STAT3, TRAIL, IRE1-TRAF-2-ASK1 signalling pathways) and enzymes inhibition (MMP-7, u-PA) may lead to apoptosis induction as well as inhibition of the following: tumorigenesis, tumor promotion, metastasis and angiogenesis. Melanoma malignum is one of the most malignant invasive cancers. It is characterized by a fast growth rate, multiple metastases, and late diagnosis. Substances of natural origin, including ursolic acid, have attracted broad attention recently, as potential antimelanoma agents. The aim of the study was to evaluate the influence of ursolic acid on the proliferation and apoptosis in human G361 malignant melanoma cell line. Material/Methods: The effect of ursolic acid on the number of G361 cells was measured using In Vitro Toxicology Assay Kit Sulforhodamine B. DNA synthesis of G361 cells was evaluated by means of BrdU colorimetric immunoassay. Detection of caspase-3 activity was performed using Caspase 3 Assay Kit, Colorimetric. Results: Ursolic acid had a strong effect on the number and proliferation of G361 cells. The most remarkable effect was observed at a concentration of 20 μM. Our results suggest that in some concentrations ursolic acid can induce apoptosis via activation of caspase-3 in melanoma G361 cells. Conclusions: The presented results suggest that ursolic acid can have an influence in a dose and time dependent manner on skin melanoma malignant cells. Ursolic acid has antiproliferative and cytotoxic activity and it can induce apoptosis in human melanoma malignum G361 cell line.

Neoplastic cannibalism and a suggestion for changes in terminology of selected epithelial tumors

The types of cell cannibalism (entosis) are described (Fig. 1 and 2), including heterocannibalism and homocannibalism (autocannibalism), in which neoplastic cells can undergo incomplete heterophagocytosis, complete heterophagocytosis, pseudocannibalism, degradation to granular bodies, transformation of benign neoplastic cells into malignant ones, reduction in clonogenic potential or the progression of malignancy of tumour cells. The author also suggests changes in the nomenclature of some epithelial neoplasms, (Fig. 3) including tumours originating from blood vessel and lymphatic endothelium (from haemangioendothelioma to carcinoma haemangioendotheliae vel carcinoma lymphangiotheliale), tumours originating from the peritoneum and pleura (from mesothelioma to carcinoma mesotheliale), malignant melanoma (from melanoma malignum to melanocarcinoma, carcinoma melanogenes), thymoma (from thymomata to carcinoma thymi) and nervous system ependymoma (from ependymoma to carcinoma ependymale). .

A melanoma malignum korai felismerését befolyásoló tényezők

Introduction and aim: Melanoma is a highly aggressive tumour with often unpredictable outcome. Our aim with this study was to determine factors influencing early detection of melanoma. Method: We analyzed 139 questionnaires completed by patients diagnosed with melanoma. Results: We found that our patients are health-conscious regarding cardiovascular diseases and attend cancer screenings on recall. However, their knowledge about melanoma is insufficient. Most of them perform skin self-examination, but they do not know what to check. Melanoma is detected mostly by the patients themselves, but it takes more than one year to consult a doctor. Our study confirmed that patients’ attitude toward melanoma is an important factor influencing early detection. We found that physical examination and communication about skin cancer prevention is not part of the routine medical care. Conclusions: It is important to improve knowledge about melanoma among the general population and health care providers and to emphasize that early detection can save lives. Orv. Hetil., 2016, 157(51), 2028–2033.