ObjectiveTo study the advance of malignant anorectal melanoma. MethodsThe literature in recent years about risk factors,clinical characteristic,early diagnosis,treatment and the prognosis of the anorectal melanoma were reviewed.ResultsMalignant anorectal melanoma was very rare.The history of pigment naevus,human immunodeficiency virus infection and sunlight exposure might be the risk factors.Clinic characteristics were rectal bleeding,anorectal mass and changing in bowel habits.Early diagnosis mainly depended on performing routine examination on patients between the ages of 45-80 years.The staining for polycolnal CEA in anorectal melanoma has a role on diagnostic pathology.The treatment is controversial and the combined treatments of chemotherapy with radiation therapy and immunotherapy which were based on surgery (abdominoperineal resection or wide local excision) are introduced.Conclusion Early diagnosis of malignant anorectal melanoma is difficult and the prognosis is poor.It is necessary to pay more attention to this disease and the most successful therapeutic approaches need to be developed.
Objective To observe the effects of operation with large-dose of RoferonA for cutaneous malignant melanoma. Methods From January 1998 to December 2005, thirtythree patients with cutaneous malignant melanoma were treated. There were 20 males and 13 females, aging 17-79 years. The disease course was 2 months to 7 years. In 33 patients, nine patients identified as clinical-stage Ⅰ received singly enlargedresection to the primary lesion and performed split-thickness skin graft dermoplasty or adjacent skin flap repair; twenty-three patients identified as clinicalstage Ⅱ received enlargedresection to the primarylesion and performed proximal lymphaden scavenge as well as received split-thickness skin graft dermoplasty; and one patient identified as clinical-stage Ⅲ received palliative resection to the primary lesion. All patients received large dose of Roferon-A after operation. Results There are no recidivation in the 9 patients of clinicalstage Ⅰ. There are 1 recidivation and 1 quit in all the 23 patientsof clinicalstage Ⅱ. One patient of clinicalstage Ⅲ died after 18 months of operation. Conclusion The operation combined with large-dose of RoferonA after operation was a more effective way to treat cutaneous malignant melanoma.
Objective To investigate the effect of Adenovirus-mediated averse vascular endothelial growth factor165（Ad-aVEGF165）on the growth of human melanoma cells(A375) in vivo and in vitro.Methods In vitro,the 100 multiplicity of infection of Aadenovirus-mediated green fluorescent protein（Ad-GFP）and Ad-aVEGF165 were transfected into human endothelium cell of vessel 304（ECV 304） and A 375. ECV 304 cells were divided into 3 groups: A 375 group, AdGFP group and AdaVEGF 165group. A375cells were also divided into 3 groups:1640 group, Ad-GFP group and AdaVEGF165 group. Their effects were analyzed by proliferation assay, cell cycle, and VEGF expression. In vivo,A375cells were injected into the axilla of the nude mouse. When the tumor formed, they were transplanted into another 15 mice. After treatment, the tumor was excised for naked eye observation, HE observation and microvascular density(MVD) counting. Results The cell supernatant fluid of A 375 group and AdGFP group could stimulate ECV304 cell growth，butthat of AdaVEGF165 group could inhibit the growth of ECV304 cell.All the A375cells in 3 groups had the proliferation trend, showing no statistically significant difference（Pgt;0.05）. ECV 304 cell proliferation index(PI) in Ad-aVEGF165group reduced（Plt;0.05）. There was no statistically significant difference（Pgt;0.05） in the PI of A 375 cell. The A 375cell integral optical densities were 234.41±13.8 in 1640 group， 222.73±3.67 in AdGFP group and 180.84±6.34 in Ad-aVEGF165group. The tumor volume in Ad-aVEGF165 group was smaller than that in Ad-GFP group and PBS group at 2 weeks after operation, the trend became much obvious with the time delay. AdaVEGF165 brought to much tissue necrosis under HE stain. The MVD of PBS group, Ad-GFP group and Ad-aVEGF165group were 65 10/view,52±11/view and 30±6/view, respectively. Conclusion In Vitro, Ad-VEGF 165gene could inhibited ECV304 cells’ growth by weakening VEGF expression of A 375cells. In vivo, Ad-aVEGF 165could inhibit the growth of human melanoma from blockinmicrovascular.
Malignant melanoma is a kind of highly malignant tumor, which mainly occurs in the skin, mucous membrane, and rarely in the breast. Here we reported a case of malignant melanoma in the chest wall skin with mammary metastasis. A sizable pigment spot on the skin of the thoracic region was found at the patient’s birth, existing for 50 years with quite atypical clinical manifestation. A nodule at 12 o’clock of the left breast was found by ultrasound four months ago, who was mistaken for a fibroadenoma. As a result, the patient received a minimally invasive excision of the breast lesion, after which the pathological report suggested malignant melanoma. By sharing this case, we aimed to discuss the diagnosis and treatment of this kind of atypical malignant melanoma in detail and provide some clinical experience.