Melanoma

Melanoma

August 31, 2007     Lester D.R. Thompson, MD, FASCP
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Bilateral cerebellopontine angle metastatic melanoma: A case report

June 30, 2007     Abraham Jacob, MD; Rebecca P. Brightman, MD; D. Bradley Welling MD, PhD
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Abstract
Although melanoma accounts for approximately 1% of all malignancies, melanoma metastases to the cerebello-pontine angles (CPAs) are exceedingly rare. Here we describe a patient with melanoma metastases to the internal auditory canals and CPAs who presented with a remote history of cutaneous melanoma. This patient had a rapidly progressive hearing loss, vestibulopathy, and facial nerve dysfunction. Magnetic resonance imaging demonstrated bilateral, enhancing CPA lesions but was otherwise nonspecific. The diagnosis required a careful history, unilateral surgical resection for tissue acquisition, and histopathologic confirmation. A search for primary cutaneous melanoma at the time of presentation was negative. However, the history of cutaneous melanoma 8 years earlier distinguishes this patient's metastatic disease from solitary primary intracranial melanoma, an equally rare disease. Treatment consists of surgical excision, radiation, chemotherapy, and immunotherapy. The prognosis for patients with melanoma metastases is generally poor, but isolated reports of long-term survival have been described. Metastatic disease to the CPAs must be included in the differential diagnosis for any patient presenting with rapid-onset VIIth or VIIIth cranial nerve symptoms.

Malignant melanoma of the sinonasal mucosa: Two case reports and a review

April 30, 2007     Alicia R. Sanderson, MD; Brendan Gaylis, MD
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Malignant melanoma of the mucous membranes of the head and neck: Three case reports

April 1, 2006     Arjun Dass, MS; Ramandeep S. Virk, MS; Harbir Hundal, MS; Harsh Mohan, MD
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Abstract
Primary malignant melanoma of the oronasal region is rare. When it does occur, it is difficult to manage, and the prognosis is not good. Early diagnosis and radical surgical management appear to offer the best hope of curing the disease. We report 3 new cases of malignant melanoma of the mucous membranes of the head and neck. Despite the generally poor outlook, 2 of these patients underwent excision of the tumor and remained disease-free 2 years later; the other patient refused surgery and was lost to follow-up.

Primary malignant melanoma of the epiglottis: A rare presentation

April 1, 2006     Rajaraman Durai, MS, MRCS; Syed Hashmi, FRCS
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Abstract
Primary malignant melanoma of the epiglottis is extremely rare. Until now, only 4 cases have been reported in the world literature. We describe a new case of epiglottic primary malignant melanoma in a 74-year-old man who presented with hoarseness and a foreign-body sensation. Clinical examination revealed the presence of a small, whitish, polypoid tumor on the laryngeal surface of the epiglottis; no other primary melanoma was detected. Wide excision of the lesion was performed, and microscopy revealed that it contained melanin-pigmented tumor cells in both the mucosa and submucosa. Immunostaining was positive for S-100 protein. The patient was treated with radiotherapy, and he remained well 1 year after the diagnosis with no evidence of recurrence.

The Karapandzic flap in recurrent melanoma of the lip

September 30, 2004     Lorraine M. Smith, MD, MPH; Ryan F. Osborne, MD
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