• Journal of the Korean Medical Association
• /
• v.61 no.11
• /
• pp.662-669
• /
• 2018

The cutaneous melanoma has been regarded as rare disease entity in Korea for long time but it shows a silent growth recently. Furthermore the management of cutaneous melanoma including staging system, surgical principle, sentinel lymph node biopsy and subsequent complete node dissection and, most importantly, immunotherapy and target therapy against cutaneous melanoma recently. The incidence of cutaneous melanoma is steadily increasing in Korea but its increase is rapid recent 2 decades to 4.3 times and should be greater soon according to the steeper increase of life expectancy. New staging system proposed by American Joint Committee on Cancer (2017) includes changes in individual TNM category and stage groups, particularly from a prognostic viewpoint. Dermoscopy has been successfully introduced in the differential diagnosis of pigmented skin lesion focusing on cutaneous melanoma by non-invasive simple diagnostic tool. Sentinel lymph node biopsy was a issue of long debate whether survival benefit is real or not. Temporary conclusion about this question is reached after two large scale studies and immediate complete node dissection should be performed in a certain situations. Most important change is drug therapy focusing on immunotherapy and target therapy. Braf- and MEK-inhibitor, immune checkpoint inhibitor and PD-1 blocker has been proved to be effective as a sole or combination regimen against advanced and/or high-risk adjuvant setting of cutaneous melanoma. In conclusion, these remarkable changes will be reviewed shortly here.

• Archives of Plastic Surgery
• /
• v.43 no.1
• /
• pp.59-65
• /
• 2016

Background In East Asia, the foot is the most common site of cutaneous melanoma. The purpose of this study was to investigate the differences between cutaneous melanoma of the foot and melanomas of other sites. Methods We studied 52 patients who underwent surgical treatment for cutaneous melanoma of the foot from September 2000 to January 2015. Through a retrospective review of their medical records, we collected data relating to their sex, age, histopathological subtype, Clark level, tumor thickness, lymph node involvement, stage, and survival rate, and we compared these parameters to those of 61 patients treated for melanoma of other sites. Moreover, we analyzed the surgical procedures, complications, and mortality rates associated with cutaneous melanoma on various parts of the foot. Results Melanoma of the foot differed from other melanomas only in the histopathological subtype. Other clinical features, including survival rate, did not differ significantly between the two groups heel was the most common site of melanoma of the foot (22 cases, 42.3%). The method of reconstruction varied depending on the region involved. Conclusions A comparison of melanoma of the foot to other melanomas showed that melanoma of the foot was associated with a significantly different distribution of histological subtypes. Consistent with previous findings, we found that the acral lentiginous subtype was the most common among melanomas of the foot. Furthermore, in contrast with previous studies, we did not find a worse prognosis or lower survival rate for melanoma of the foot in comparison with other melanomas.

• Archives of Plastic Surgery
• /
• v.42 no.6
• /
• pp.746-752
• /
• 2015

Background This study analyzed 100 consecutive patients with primary cutaneous melanoma over the course of 13 years to determine whether epidemiological differences correspond to different stages of the disease. We also investigated whether epidemiological characteristics affected the survival rate. Our results were compared with those of selected descriptive studies of melanoma in other East Asian populations, in order to determine whether cutaneous melanoma patterns are similar in East Asian populations. Methods The patients' medical records were reviewed retrospectively, and we analyzed the relationship of epidemiological characteristics to staging and survival rate. Additionally, papers from Hong Kong and Japan describing these phenomena in East Asian populations were subjected to a statistical comparison. Results The ratio of males to females was 1:1.8, and the foot was the most frequent tumor site (49%). Acral lentiginous melanoma occurred most frequently (55%). Nodular melanoma was associated with a higher stage. Stage III-IV tumors with Clark levels of IV-V were significantly associated with a low survival rate. A statistical analysis of comparable papers reported in Hong Kong and Japan showed similar results with regard to age, tumor location, and histopathological subtypes. Conclusions This study provides the first full epidemiological description of 100 consecutive cases of primary cutaneous melanoma in Korea, with results similar to those observed in other East Asian populations. Corresponding to previous findings, nodular melanoma tended to occur at a higher stage than other types, and tumors with high Clark levels and high stages showed a lower survival rate.

• Radiation Oncology Journal
• /
• v.37 no.1
• /
• pp.51-59
• /
• 2019

Purpose: We evaluated failure pattern and treatment outcomes of observational approach on regional lymph node (LN) in cutaneous melanoma of extremities and sought to find clinico-pathologic factors related to LN metastases. Material and Methods: We retrospectively reviewed 73 patients with cutaneous melanoma of extremities between 2005 and 2016. If preoperative 18-F-fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) findings were non-specific for regional LNs, surgical resection of primary tumors with adequate margins was performed without sentinel lymph node biopsy (SLNB) and/or complete lymph node dissection (CLND), irrespective of tumor thickness or size. In patients with suspicious or positive findings on PET/CT or CT, SLNB followed by CLND or CLND was performed at the discretion of the surgeon. We defined LN dissection (LND) as SLNB and/or CLND. Results: With a median follow-up of 38 months (range, 6 to 138 months), the dominant pattern of failure was regional failure (17 of total 23 events, 74%) in the observation group (n = 56). Pathologic LN metastases were significant factor for poor regional failure-free survival (hazard ration [HR] = 3.21; 95% confidence interval [CI], 1.03-10.33; p = 0.044) and overall survival (HR = 3.62; 95% CI, 1.02-12.94; p = 0.047) in multivariate analysis. In subgroup analysis for cN0 patients according to the preoperative PET/CT findings, LND group showed the better trend of LRFFS (log rank test, p = 0.192) and RFFS (p = 0.310), although which is not statistically significant. Conclusion: Observational approach on regional LNs on the basis of the PET/CT in patients with cutaneous melanoma of extremities showed the dominant regional failure pattern compared to upfront LND approach. To reveal regional lymph node status, SLND for cN0 patients may of importance in managing cutaneous melanoma patients.

• Archives of Craniofacial Surgery
• /
• v.21 no.2
• /
• pp.132-136
• /
• 2020

Oral mucosal melanoma is a very rare type of malignant melanoma, the characteristics of which differ from those of cutaneous melanoma. Primary amelanotic melanoma of the mandibular gingiva, which can invade the mandibular bone, is very rare worldwide. Here, we report a case in which we performed a reconstruction of the mandible and gingiva using the fibula osteocutaneous free flap procedure to treat a patient diagnosed with a primary amelanotic melanoma of the mandibular gingiva. The procedure was successful, and no recurrence was observed 10 months after surgery. Oral mucosal melanoma has a much poorer prognosis and a lower 5-year survival rate than cutaneous melanoma. However, recently, immunomodulatory therapies for mutations in melanocytic lesions have been used effectively to treat the increasing number of patients developing this type of melanoma, thus improving the prognosis of patients with oral mucosal melanoma.

• Obstetrics & gynecology science
• /
• v.61 no.6
• /
• pp.698-701
• /
• 2018

We report a rare case of vaginal amelanotic melanoma. Malignant melanomas are cutaneous and extracutaneous tumors that arise from embryological remnants of neural crest cells/melanocytes. Amelanotic melanomas at such rare locations can be misdiagnosed both clinically and radiologically. Therefore, histopathological examination and immunohistochemistry are mandatory for the diagnosis of these tumors. We diagnosed this case using histopathology and confirmed the diagnosis based on the presence of immunohistochemical markers human melanoma black 45 (HMB45) and S-100.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.1
• /
• pp.533-537
• /
• 2013

Background: Malignant melanoma is a cancer that demonstrates rapid progression and atypical clinically features with a poor prognosis. Aim: This study was performed to determine the clinical characteristics and treatment outcomes of patients with malignant melanoma in Turkey. Methods: The medical records of 98 patients between 2007-2012 at our centers were retrieved from the patient registry. Overall survival (OS) was calculated using the Kaplan-Meier method. Results: In our study, with the median follow-up of all patients with cutaneous MM of 46.3 months, the median OS rate of all cases was 43.6 months and 5-year OS was 48.6%. However, five-year OS rates of patients with localized disease (stage I-II) and node involvement (stage III) were 60.3% and 39.6%, respectively. The median OS of stage IV patients was 8.7 months and 1-year OS rate was 26.2%. We showed that advanced stage, male gender, and advanced age in all patients with MM were significant prognostic factors of OS. Conclusions: Compared with the results of current studies from Western countries, we found similar findings concerning demographical features, histological variables and survival analyses for our patients with cutaneous MM in Turkey.

• Korean Journal of Head & Neck Oncology
• /
• v.13 no.1
• /
• pp.3-8
• /
• 1997

Malignant melanoma has a very poor prognosis compared to other cancers. There are no specific tumor markers other than clinical staging and depth of invasion to predict the prognosis of the malignant melanoma. The nm23 has been known to inhibit the metastasis of the malignant melanoma, some studies showed that it is highly expressed in the malignant melanoma cell line which has a relatively weak metastatic potential. In this study, we compared the expression of nm23 in mucosal type with that in cutaneous type of the malignant melanoma in the head and neck according to the stage and survival rate to identify the role of nm23 expression as a prognostic factor in mucosal melanoma of the head and neck. Six out of eight cases in mucosal type and seven out of 11 cases in cutaneous type expressed nm23, which showed no significant differences. Between the two groups there were no significant differences in expression of nm23 according to clinicopathologic staging or two year survival rate. However, in cases with low cliniopathological staging and those surviving more than two years the expression was significantly increased which suggests that expression of nm23 can be used as an aid in determining the prognosis of mucosal melanoma.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.9
• /
• pp.3873-3877
• /
• 2014

Melanoma of the skin is a malignant tumor, which incidence is still increasing. It was estimated that in the United States one person died from this cause every hour. The major risk factor of this disease is exposure to ultraviolet radiation, especially associated with the occurrence of sunburns. Patients diagnosed with distant metastases have median survival of 6-9 months. The aim of this paper was to identify the causes of delayed diagnosis of melanoma as diagnosis at an early stage seems to be the key to improve the survival rates. For this purpose, a search of medical databases such as PubMed, Google Scholar and Cancer Registers was conducted and an analysis of the literature from the years 1979-2013 was conducted.

• Korean Journal of Veterinary Research
• /
• v.46 no.3
• /
• pp.275-278
• /
• 2006

A 7-month-old brown pig with a discoid and pedunculate mass measuring $14.0{\times}12.5{\times}2.5cm$ on the skin of the right shoulder was noted at the slaughter house in Jeju. The surface of mass approximately $7{\times}4cm$ was interfaced with skin. The color of mass with firm consistency was mainly black and partially white on cut surface. Histopathologically, numerous unencapsulated endocrine-like cellular nodules of epithelioid cell type with abundant intracytoplasmic black pigment, melanin, were occupied in dermis and subcutis. Most of nodules in deep dermis were surrounded by lightly pigmented spindle cells and loose fibrous tissues. Mitotic figures were infrequently observed. The overlying epidermis was hyperplastic due to the down-growth of rete peg. Based on the gross and histopathologic findings, this case was diagnosed as cutaneous melanoma. In our best knowledge, this is the first case of swine cutaneous melanoma in Korea.