mart-1-antigen and Eyelid-Neoplasms

To report the clinical and histopathologic features of two cases of eyelids metastases from uveal melanoma diagnosed in a metachronous and synchronous fashion.. Monocentric retrospective case series of histopathologically proven eyelids metastases from uveal melanoma at our institution.. Two patients were presented to our hospital for upper eyelids pigmented and firm lesions. Patient 1 had an history of left uveal melanoma treated conservatively with proton beam therapy 5 years earlier. Examination revealed bilateral upper eyelids lesions. Patient 2 had no malignancy history but was incidentally diagnosed with a cerebral nodule few months earlier. Examination revealed a right upper eyelid nodule and a previously unknown right uveal melanoma. Excisional biopsy was performed for both patients. Pathological assessment allowed the presence of melanoma cells. The lack of BAP1 nuclear expression on immunohistochemistry as well as the absence of cutaneous or mucosal melanoma were consistent with an uveal origin. Diffuse metastatic spread was noted for both patients. Systemic therapies were prescribed. Patient 1 died from metastatic spread (62 months and 4 months after uveal melanoma diagnosis and eyelids metastases removal, respectively) whereas patient 2 was still alive (14 months follow up).. Eyelids metastases from uveal melanoma is an exceptional finding. Excisional biopsy and pathological assessment are of main importance to confirm the diagnosis and to identify genetic mutations for further targeted therapies. Currently, prognosis remains poor.

Topics: Aged; Biomarkers, Tumor; Biopsy; Combined Modality Therapy; Eyelid Neoplasms; Fatal Outcome; Humans; Immunotherapy; Male; MART-1 Antigen; Melanoma; Middle Aged; Prognosis; Proton Therapy; Retrospective Studies; Tumor Suppressor Proteins; Ubiquitin Thiolesterase; Uveal Neoplasms

To report the findings on sentinel lymph node biopsy (SLNB) in 30 patients with ocular adnexal (conjunctival or eyelid) melanomas.. Prospective nonrandomized clinical trial.. Thirty patients with diagnosis of eyelid or conjunctival melanoma.. All patients with ocular adnexal melanoma who underwent SLNB at The University of Texas MD Anderson Cancer Center between December 2000 and July 2008 are the subject of this report. Sentinel lymph node biopsy was performed as previously described by our group, and patients were prospectively followed up.. Findings on preoperative lymphoscintigraphy, SLNB, histopathologic examination of the primary tumor and sentinel lymph nodes (SNL), and nodal recurrence after SLNB.. Tumor sites were as follows: bulbar conjunctiva only, 14 patients; palpebral conjunctiva only, 8 patients; both bulbar and palpebral conjunctiva, 4 patients; and eyelid skin only, 4 patients. At least 1 SLN was identified in all patients. The median number of SLNs removed was 2 (range, 1-5). The most common basin sampled was the intraparotid (16 patients), followed by submandibular (level I) (11 patients), preauricular (9 patients), and superior cervical (level II) (6 patients). Five patients had SLN metastasis. Among the 25 patients with negative SLNB findings, there were 2 false-negative events. There were no false-negative events among patients treated during the last 4.5 years of the study. The mean Breslow thickness was 2.57 mm (range, 0.62-12 mm) among patients with negative SLNB and 4.86 mm (range, 2.0-7.2 mm) among patients with positive SLNB findings (P = 0.055). Ulceration was present in 11 patients (39%): 4 (80%) of 5 patients with positive SLNB and 7 (28%) of 25 with negative SLNB, including both patients with false-negative results. The median time from SLNB to last contact was 2 years (range, 10 months to 6 years).. Sentinel lymph node biopsy is effective for identifying nodal micrometastasis in patients with ocular adnexal melanoma and provides important prognostic information. The false-negative event rate in our series improved in the last 4 years, most likely because of a better technique and better patient selection for SLNB. We recommend consideration of SLNB for patients with intermediate-thickness ocular adnexal melanoma and those with ulceration.

Topics: Adult; Aged; Aged, 80 and over; Antigens, Neoplasm; Conjunctival Neoplasms; Eyelid Neoplasms; False Positive Reactions; Female; Humans; Lymph Nodes; Lymphatic Metastasis; Male; MART-1 Antigen; Melanoma; Melanoma-Specific Antigens; Middle Aged; Monophenol Monooxygenase; Neoplasm Proteins; Predictive Value of Tests; Prognosis; Prospective Studies; Sentinel Lymph Node Biopsy; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Divided nevus with verrucous hyperplasia will always recur after surgery but non-verrucous divided eyelid nevus rarely recur. This study analyzed the differential expression of Ki-67, S100, Melan A and HMB45 and identified the correlation between the clinical and histopathological features of verrucous and non-verrucous divided eyelid nevus.. This study included 29 patients, of whom 8 patients had verrucous divided nevus. Immunohistochemistry labeling was used to assess the expression of Ki-67, S100, Melan A and HMB45 after excision. The difference between verrucous and non-verrucous divided eyelid nevus was analyzed.. The patients' ages ranged from 2 to 59 years, with a mean age of 19 years. The lesion size ranged from 1.5 to 2.0 cm in diameter and invaded the eyelid margins and the posterior lamella of the eyelids. Immunohistochemistry labeling showed strong positivity for approximately 98.5% of S100 and positive staining for approximately 27.6% of Ki-67, 72.4% of Melan A and 6.8% of HMB45. However, Ki-67 was significantly upregulated in verrucous divided nevus of the eyelids compared with non-verrucous divided nevus, with approximately 38.8% upregulation in verrucous and 18.3% upregulation in non-verrucous nevus.. This study correlated the clinic-pathologic features of verrucous divided eyelid nevus by means of statistically analyzing the varied clinical features and pathological impressions. The significant over-expression of S100 may be used as an indicator of divided nevus of the eyelids, and the over-expressed Ki-67 may contribute to the recurrence of verrucous divided nevus. High expression of HMB45 and Melan A may represent malignant transformation.

Topics: Adolescent; Adult; Antibodies, Monoclonal; Child; Child, Preschool; Eyelid Neoplasms; Eyelids; Humans; Ki-67 Antigen; MART-1 Antigen; Middle Aged; Nevus; Nevus, Pigmented; Skin Neoplasms; Young Adult

Topics: Biomarkers, Tumor; Diagnosis, Differential; Eyelid Neoplasms; Humans; Infant; Ki-67 Antigen; Male; MART-1 Antigen; Nevus, Epithelioid and Spindle Cell; Ophthalmologic Surgical Procedures; Skin Neoplasms

Melanoma can present with protean combinations and permutations of histologic features mimicking a plethora of nonmelanocytic benign and malignant proliferations. Anecdotal cases of melanoma closely simulating fibrohistiocytic proliferations have been reported. At times, the reliable differentiation between melanoma and histiocytic proliferations could be vexing histopathologically. We report an unusual presentation of melanoma in an 87-year-old man strikingly resembling xanthogranuloma both clinically and histopathologically. Histologic sections revealed a diffuse proliferation of pleomorphic cells some with foamy cytoplasm and occasional Touton-like giant cells in the dermis accompanied by inflammatory cells. Rare single-cell pagetoid scatter was evident within the epidermis. The infiltrate had patchy staining on CD163, interpreted as part of the inflammatory component but the atypical cells stained heavily with Melan A and tyrosinase confirming the diagnosis of malignant melanoma. Our case demonstrates yet another face of malignant melanoma and the critical but judicious use of immunohistochemistry in reliably distinguishing between melanoma and histiocytic tumors.

Topics: Aged, 80 and over; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Biomarkers, Tumor; Biopsy; Diagnosis, Differential; Eyelid Neoplasms; Granuloma; Histiocytosis; Humans; Immunohistochemistry; Male; MART-1 Antigen; Melanoma; Monophenol Monooxygenase; Predictive Value of Tests; Receptors, Cell Surface; Skin Neoplasms; Xanthomatosis