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PubMed1991

Childhood Ki-1 lymphoma: presentation as a buttock mass.

Ki-1 lymphoma is a rare, large-cell anaplastic non-Hodgkin's lymphoma that most commonly affects older children and young adults. Presentation usually occurs as a localized infiltration of the skin and lymph nodes. We report an unusual case of childhood Ki-1 lymphoma that presented as a buttock mass in an eight-year-old girl, Pathologic evaluation revealed the characteristic lymphoma cells expressing Ki-1 antigen (CD-30), HLA-DR, interleukin 2 (CD-25), T-cell gene rearrangement, and the cytogenetic karyotype t(2;5). The patient is in complete remission following treatment with combination chemotherapy. This report broadens the clinical spectrum associated with Ki-1 lymphomas and illustrates the importance of combining routine pathologic examination with other specialized diagnostic techniques in the evaluation of childhood soft-tissue masses.

Aneuploidy↗

PubMed1990

Clinical evaluation of chemotherapy under angiotensin II-induced hypertension in patients with advanced cancer.

The clinical efficacy and indications for Angiotensin II (AT II)-induced hypertension chemotherapy were evaluated as a drug delivery system in 101 patients with advanced carcinoma. The sites of primary tumor studied included stomach (44), pancreas (18), colon (16), esophagus (6), bile duct (4), liver (3), breast (7) and 3 other single organs. Seventy four cases had distant metastases (lymph node (25), liver (29), peritoneum (16), and lung (4)). Additionally, the protocol was used 12 cases as postoperative adjuvant chemotherapy and 15 cases following exploratory laparotomy. The blood pressure was elevated to a level 1.5 times base-line. The regimens used consisted of MMC + ADR (55), FAM (38) and CDDP (8). The dosages administered were MMC 7 mg/m2, ADR 14 mg/m2 and 5-FU 350 mg/m2. The cancer chemotherapy protocol with AT II was repeated for an average of 2.6 cycles with a 2-3 week interval. The drug concentration in tumor tissues was increased 1.7 fold by AT II treatment. The response rate was 15.8% (CR 7 and PR 9), and in those patients with lymph node, liver and peritoneal metastases was 48.0, 6.9 and 6.3%, respectively. The serum levels of tumor markers decreased in 9 patients. Subjective symptoms, such as hoarseness, edema and pain, were improved. The mean survival in patients with distant metastasis who responded was 343 days, and in nonresponders was only 168 days (p less than 0.05). The side effects of this therapy were slight, typically being grade 1 and 2. Thus, the chemotherapeutic agents studied in conjunction with AT II were effective in patients with lymph node metastasis. Additionally, this regimen could be performed safely with minimal side effects.

Aged↗

PubMed1983

Clinical significance of routine follow-up examinations in patients with metastatic cancer of the prostate under hormone treatment.

The results of clinical examination, skeletal X-ray, bone scan and phosphatase determinations in serum were analyzed in 30 patients with metastatic prostatic cancer prior to and during anti-androgenic treatment. Bone scan revealed skeletal metastases in all 30 patients, whereas X-ray showed bone metastases in only 22 patients. Radiological pseudoprogression and scintigraphic flair reaction were relatively frequent findings during the first 3-8 months of effective hormone therapy. Later on progressive changes on X-ray and bone scan were well related to clinical progression of the disease and indicated a poor prognosis in the individual patient. Soft tissue metastases most often responded well to the initial hormone treatment, but regrew only rarely during later disease progression. Changes of the radioimmunologically determined prostatic acid phosphatase seemed most often to indicate the presence of advanced disease and subsequent disease progression. Second line treatment of hormone-unresponsive prostatic cancer is at best palliative and has not been proved to prolong the survival in most of the patients. In routine clinical practice, the need for such second line therapy is dependent on the patient's symptoms and not on the early detection of progressive changes on X-ray, bone scan or blood tests. Therefore it seems unnecessary to perform these examinations regularly in hormone-treated asymptomatic patients with advanced prostatic cancer unless the patient is entered into a clinical research program.

Acid Phosphatase↗

PubMed1996

A phase II study of CI-973 [SP-4-3(R)]-1,1-cyclobutane-dicarboxylato (2-)] (2-methyl-1,4-butanediamine-N, N') platinum in patients with refractory advanced breast cancer.

CI-973 is a water-soluble platinum diamine complex whose antitumor activity is greater than that of cisplatin in some murine tumors. It has shown activity against cisplatin-resistant tumors. This phase II trial had the objectives of determining the therapeutic efficacy of CI-973 in patients with metastatic breast cancer who had been treated with one prior chemotherapy regimen, and of further defining the toxicity of the agent and the reversibility of its toxicity. CI-973 was administered as an intravenous infusion over 30 min with no prehydration or antiemetic programs. Treatment cycles were repeated at 21-day intervals. Patients with histologically confirmed metastatic breast cancer, measurable disease, and good performance status who had received only one prior chemotherapy regimen for metastatic disease were eligible for treatment. Adequate hematologic, renal, and hepatic function were required. A total of 26 patients received a median of two courses of CI-973 (range, 1-18 courses). Hematologic toxicity was severe: nearly all patients experienced granulocytopenia with granulocyte counts of 0 at all dose levels. Nevertheless, neutropenic fever and documented systemic infection were uncommon, and there were no hospitalizations for neutropenic fever or infection. Visceral disease dominated in this patient group. Of the 26 patients, 14 had visceral disease, 6 had bone or bone marrow disease, and 6 had skin, soft-tissue, or lymph-node disease. Of the 26 patients treated, 25 were evaluable for response. There were two partial remissions, one in liver and one in bone, and three minor responses, for a response rate of 8%. Nonhematologic toxic effects were mild and consisted of nausea and vomiting, fatigue, minimum peripheral paresthesia, and hypomagnesemia. Further study of CI-973 at the dose and schedule used in this study is not warranted. Because this agent had no significant extramedullary toxicity, intensification of the dose of CI-973 with concomitant administration of colony-stimulating factors has the potential to improve response in this patient population.

Adult↗

PubMedDate not supplied

Mucin-like carcinoma-associated antigen (MCA) in breast cancer: clinical experience at the National Cancer Institute of Milan.

Mucin-like Carcinoma-associated Antigen (MCA) is a glycoprotein belonging to the mucin family; it is defined by the monoclonal antibody b-12. Mucins represent an interesting group of tumor markers and are widely utilized in the clinical monitoring of neoplastic patients. These molecules show a certain degree of tissue specificity and MCA is preferentially associated with breast tissue. Several studies have demonstrated that patients with breast cancer usually have high MCA serum levels. In this paper the experience of the National Cancer Institute of Milan with the clinical use of MCA in breast cancer patients is reported. The observed sensitivity of the MCA test was poor in patients with early-stage disease, while it was acceptable in patients with advanced breast cancer. MCA concentrations appeared to be directly related to disease spread. A clear relationship was seen between MCA levels and lymph-nodal status. The highest MCA plasma levels were observed in patients with metastatic disease. In this group of patients the sensitivity of the test on the basis of a cut-off of 11 U/mL was 52%.

Adenofibroma↗

PubMed2006

Signal transducers and activators of transcription-3 up-regulates tissue inhibitor of metalloproteinase-1 expression and decreases invasiveness of breast cancer.

Signal transducers and activators of transcription (STAT)-3 is an oncogenic protein that is constitutively activated in many human cancers, including 30 to 60% of primary breast cancer. The biological significance of STAT3 activation in breast cancer is not fully understood. We have previously shown that STAT3 up-regulates tissue inhibitors of metalloproteinase (TIMP)-1, a cytokine known to block metalloproteinases and decrease invasiveness in certain cancer cell types. We hypothesize that STAT3 activation may modulate tumor invasiveness of breast cancer by regulating TIMP1 expression. Using MCF-7 cells transfected with tetracycline-off STAT3C (constitutively active STAT3), we generated an in vitro system in which STAT3C levels can be tightly controlled in breast cancer cells. Increasing tetracycline levels gradually decreased STAT3C and TIMP1 in a dose-dependent manner, and down-regulation of these proteins led to a reciprocal decrease in invasiveness of these cells in Matrigel. Addition of a neutralizing anti-TIMP1 antibody increased invasiveness in the same experimental system. Using immunohistochemistry and 142 primary breast tumors, we found a significant association between the expression of the phosphorylated/active form of STAT3 (pSTAT3) and that of TIMP1. Importantly, STAT3 activation correlated significantly with a lower frequency of vascular and lymphatic invasion (P = 0.015 and P = 0.0002, respectively). Our data support the concept that STAT3 activation significantly modulates the biological and clinical behavior of breast cancer.

Adult↗

PubMed2004

Soft tissue deposits in neck dissections of patients with head and neck squamous cell carcinoma: prospective analysis of prevalence, survival, and its implications.

BACKGROUND: Soft tissue deposits of squamous cell carcinoma in the necks of patients with squamous cell carcinoma of the upper aerodigestive tract may represent either total effacement of a lymph node by carcinoma or extralymphatic deposits of carcinoma. There are few reports of their clinical or prognostic significance. METHODS: Data from 215 neck dissections from 155 patients with squamous cell carcinoma of the upper aerodigestive tract were studied prospectively to assess the prevalence of soft tissue deposits within the neck. The case notes of these patients were subsequently reviewed to analyze the effect on both the overall survival and recurrence-free survival. RESULTS: The prevalence rate for soft tissue deposits occurring alone was 10.3%; the prevalence rate for soft tissue deposits occurring with extracapsular spread was 13.5%. The overall prevalence rate for soft tissue deposits was 23.9%. There was a statistically significant reduction in actuarial and recurrence-free survival in patients with soft tissue deposits compared with patients with pathologically node-negative necks (P=.001), and in patients with soft tissue deposits compared with those with pathologically node-positive necks without extracapsular spread (P=.001). No statistically significant differences were found between patients with soft tissue deposits and patients with pathologically node-positive necks with extracapsular spread, for actuarial survival or recurrence-free survival. CONCLUSIONS: In this series, soft tissue deposits were associated with an aggressive clinical course and poor survival. It is therefore important that histopathologists agree on a uniform terminology when reporting soft tissue deposits and actively look for their presence when examining neck dissection specimens.

Head and Neck Neoplasms↗

PubMed2005

[Expression of COX-2 protein in colorectal carcinoma and the clinical implication].

OBJECTIVE: To investigate the relationship between COX-2 expression and the clinicopathological factors in colorectal carcinoma and assess the prognostic value of COX-2 detection. METHODS: Tissue microarray and immunohistochemistry by SABC method was employed for detecting COX-2 expression in 126 patients with advanced colorectal cancer, and the relationship of COX-2 expression with the clinicopathological features and prognosis of the patients was retrospectively analyzed. RESULTS: The patients were divided into two groups of low and high COX-2 groups according to the grade and extent of COX-2 expression. High COX-2 expression was detected in 32 (25.4%) cases, and low expression in 94 (74.6%) cases. No significant correlation was noted between COX-2 expression and the patients' age, sex, tumor size, tumor location, histological type, lymphatic-node metastasis and Dukes' classification, but high COX-2 expression was strongly correlated with tumor recurrence and especially with blood-borne metastasis (P<0.05). The survival rate without tumor recurrence for high- and low-COX-2 groups was assessed by the Kaplan-Meier method and compared by log-rank test, which revealed significant difference between the two groups (P=0.0067). Multivariate analysis for all patients suggested that among the 8 prognostic factors (age, sex, tumor size, tumor location, histological type, lymphatic-node metastasis, Dukes' stage, and COX-2 expression), Dukes' stage and COX-2 expression was the independent significant factor related to disease-free survival. CONCLUSION: The expression of COX-2 is strongly correlated with recurrence of colorectal cancer, especially with blood-borne metastasis. COX-2 is an independent factor for prognostic evaluation of the patients, and tissue microarray allows rapid, convenient, economic and accurate COX-2 detection for large-scale application.

Adenocarcinoma↗

PubMed1987

The relationship of collagenolytic activity to stage of human colorectal carcinoma.

Collagenolytic enzymes produced by tumor cells are believed to play a significant role in the destruction of surrounding normal tissue and, in certain experimental animal systems, the ability of tumor cells to degrade type-IV collagen (basement membrane collagen) correlates positively with those cells' metastatic capacity. We measured collagenolytic activity levels of extracts from freshly excised colorectal carcinoma tissues and of conditioned media from primary organ culture (total of 114 tissues from 53 patients) by using purified radiolabelled type-I (rat tail) and type-IV (mouse Engelbreth-Holm-Swarm [EHS] sarcoma) collagens. Both type-IV and type-I collagenolytic activity levels of extracts from tumor and adjacent mucosa ranged from less than 1 to 80 ng/hr/mg wet tissue, and no significant differences between mucosa and carcinoma tissues were observed. In conditioned media, the type-IV collagenolytic activity was low for normal mucosa and benign tumors and slightly higher for carcinoma than for mucosa. In 5 of 32 primary tumors, collagenolytic activity levels were 2-5 times higher than in the rest of the tumors and mucosal tissues. There were no significant differences in collagenolytic activity levels of conditioned media and tissue extract from colorectal carcinoma of different Dukes' stages. Deep and superficial areas of primary tumors released similar type-IV collagenolytic activity levels, suggesting that there was little intratumoral heterogeneity in the release of this enzyme.

Collagen↗

PubMed1986

[Prognostic factors in sarcomas of the soft tissues].

The reported 5-year survival rate for patients with soft-tissue sarcomas varies from 40% to 60%. This substantial mortality rate is attributed to the well recognized propensity of soft-tissue sarcomas for both local recurrence and hematogenous dissemination. The main prognostic factors in resectable sarcomas include histologic grade, size and site of primary tumor as well as an adequate surgery. The frequency of local recurrence is highly variable (10% to 60%), depending on the site of primary tumor and the extent of surgery performed. The lungs are the most common site (70-80%) of all metastases. The prognosis for patients with a locally recurrent tumor, which is fully resectable in the absence of metastases, is similar to the prognosis for patients whose tumors are fully resected and have no history of local recurrence. The outcome for patients with recurrent disease depends on the site of recurrence, rather on the site of the primary sarcoma. Current survival data support an aggressive approach to resection of isolated pulmonary metastases. The prognostic value of adjuvant and neoadjuvant (intra-arterial) chemotherapy is not yet fully established. In patients with disseminated disease and treated with chemotherapy, performance status remains the single most important prognostic factor.

Humans↗

PubMed1994

[Treatment results of soft tissue sarcomas in adults].

PURPOSE: An appropriate therapeutical concept for soft tissue sarcomas is unknown particularly since that our knowledge about these neoplasms is considerably incomplete partly resulting from a low incidental rate distributed to many subentities. Children and adolescents were aggressively and multimodally treated. The standard therapy of the adults is an resection as radical as possible followed by adjuvant radiotherapy. The aim of our study was to show the treatment results of our clinic and to investigate survival rates, local tumor control and prognostic factors. PATIENTS AND METHODS: Between 1965 and 1989, a total of 51 male and 49 female were treated for soft tissue sarcoma at the University Hospital of Münster. RESULTS: The overall five-year survival rate (actuarial survival) was 43.1%. 27% of the patients developed a local recurrence, 45% distant metastases. Lymph node metastases occurred in 4% of the patients. Tumor size was a prognostic factor for the five-year survival rates (T1 = 59.8%, T2 = 44.0%, T3 = 26.0%). The best results were achieved after combined treatment using surgery (wide resection) and postoperative high dose radiotherapy. Compared to wide resection alone, the combined treatment had a significantly higher five-year survival rate (59.7% vs. 26%). There was no significant improvement using adjuvant postoperative chemotherapy. CONCLUSION: In our study we could show a remarkable improvement of the five-year survival rate by adjuvant radiotherapy after surgical resection versus surgery alone and demonstrate the importance of radiotherapy in the treatment of soft tissue sarcoma.

Adolescent↗

PubMed1994

Effect of tissue inhibitor of the matrix metalloproteinases-2 expression on the growth and spontaneous metastasis of a human melanoma cell line.

In this study, we examined the effect of expression of tissue inhibitor of metalloproteinases-2 (TIMP-2) on the growth and dissemination of a highly metastatic human melanoma cell line (M24net). M24net melanoma cells express a number of matrix metalloproteinases (MMPs), including gelatinase A and B (MMP-2 and MMP-9) and interstitial collagenase (MMP-1) (A. M. P. Montgomery et al., Cancer Res., 53: 693-700, 1993). The activity of these proteases was effectively down-regulated by transfecting M24net cells with complementary DNA-encoding human TIMP-2. Overexpression of TIMP-2 markedly reduced melanoma growth in the skin of immunodeficient mice but did not prevent these highly malignant cells from spontaneously metastasizing to the lungs and lymph nodes of inoculated mice. We provide a mechanism to account for the growth inhibitory property of TIMP-2 based on its ability to regulate M24net cell growth in three-dimensional interstitial collagen. In the presence of this matrix, M24net cells assume a differentiated morphology and have a reduced growth rate. We present evidence that overexpression of TIMP-2 increases the susceptibility of M24net cells to growth inhibition and morphological differentiation by occluding interstitial collagen.

Animals↗

PubMed1983

Synovial sarcoma. A clinicopathologic and ultrastructural study of 42 cases.

This clinicopathologic study concerns 42 cases of synovial sarcoma (13 biphasic and 29 monophasic), including electron-microscopic examination of five cases, among 753 cases of soft tissue sarcomas. The age of the patients ranged from 9 to 70 years, with a median of 35 years. Tumors occurred most commonly on the extremities with 31 on the lower extremities. Histologically the monophasic type on this occasion included tumors with focal or minimal biphasic differentiation (9 cases) in addition to totally monophasic tumor (20 cases). A comparative light microscopy revealed otherwise inappreciable differences in histologic characteristics between the monophasic synovial sarcoma and certain other spindle cell sarcomas. Ultrastructurally, the cells composing the spindle-cell area of the synovial sarcoma contained basically the same elements as did the cells forming epithelioid or gland-like structures, and as the cells in the areas of gradual transitions of the two. One exception was that the cells lining the gland-like lumina had microvillar projections. Characteristic secretory-like granules, similar to those seen in the synovial type B cell of the normal human synovium, were evident in all five cases studied electron microscopically. In contrast to the findings of others, patients with monophasic tumors had a better prognosis, 58% surviving 5 years compared to 36% for those with biphasic tumors.

Adolescent↗

PubMed1993

Rhabdomyosarcoma.

In children and young adults, rhabdomyosarcoma occurs with a frequency that is equal to or greater than that of all the other forms of soft-tissue sarcoma combined. Although the responsiveness of rhabdomyosarcoma to chemotherapy varies greatly among tumors with different primary sites and with different histologic features, the overall results of chemotherapy have been more impressive in rhabdomyosarcoma than in any other form of soft-tissue sarcoma. Rhabdomyosarcomas occur in almost all sites and age groups. Those that occur in trunk and extremity sites have an unusually high instance of alveolar or undifferentiated histologic features and are more common in older children and young adults. Although they constitute only one third of all patients with rhabdomyosarcoma, tumors that are primary in trunk and extremity sites present some of the most difficult therapeutic problems in the management of all patients with this tumor. The ability to accomplish an initial complete local tumor excision still represents a major factor in survival. Early reexcision in the case of incompletely excised tumors with small volumes of residual tumor is effective when feasible. Local control of rhabdomyosarcoma can be achieved by high-dose irradiation and frequently by lower-dose irradiation when given in conjunction with chemotherapy. Second-look surgery is an accurate predictor of outcome, and late excision of residual tumor after chemotherapy-radiation therapy regimens may influence outcome. A regimen of vincristine, actinomycin-D, and cyclophosphamide given as a "pulse", with or without Adriamycin (doxorubicin), is the standard chemotherapy with cisplatin, etoposide, melphalan, and other agents now under study in trials of the Intergroup Rhabdomyosarcoma Study.

Adult↗

PubMed2006

Invasive colorectal micropapillary carcinoma: an aggressive variant of adenocarcinoma.

Micropapillary carcinoma (MC) has been well described in other organs, including breast, urinary bladder, lung, ovary, and salivary gland, but has not been described in the large intestine. We compared the clinicopathologic and immunohistochemical findings of MC with those of conventional adenocarcinoma in the large intestine. Fifty-five cases of adenocarcinoma with an MC component were identified among 585 consecutive cases of colorectal cancer at the Asan Medical Center between January 2003 and June 2004 and were compared with 119 cases of conventional adenocarcinoma of colorectum without an MC component. Arrayed tissue blocks were constructed and immunostained for cytokeratin 7 and 20 and CDX2. We also compared the results of MLH-1, MSH-2, p53, and carcinoembryonic antigen immunostainings between the 2 groups. The grade of both MC and conventional adenocarcinoma was mostly moderately differentiated. The proportion of MC ranged from 5% to 80%. The presence but not extent of MC in the primary tumors was associated with more frequent lymphovascular invasion and lymph node (LN) metastases, a greater mean number of positive LNs, and a higher tumor stage with more frequent distant metastases, compared with conventional adenocarcinoma (P < .05). Cytokeratin 7 staining was occasionally observed in both MC (9.1%, 5/55 cases) and conventional adenocarcinoma (13.4%, 16/119 cases). Although MLH-1 and CDX2 expression tended to be lower in conventional adenocarcinoma, none of the immunohistochemical results was significantly different between 2 groups. Recognition of MC component is important as MC appeared to be an aggressive variant of colonic adenocarcinoma and presented at a higher stage, with frequent lymphovascular invasion, LN metastasis, and distant metastasis, compared with conventional adenocarcinoma. The proportion of MC component did not impact the prognosis, and the immunoprofiles of MC were not significantly different from those of conventional adenocarcinoma.

Adenocarcinoma↗

PubMed2004

An immunohistochemical study of TIMP-3 expression in oesophageal squamous cell carcinoma.

Tissue inhibitor of metalloproteinase-3 (TIMP-3) inhibits the activity of matrix metalloproteinase, which may play an important role in carcinoma invasion and metastasis. We have investigated the relationship between TIMP-3 reduction and clinicopathological factors in oesophageal squamous cell carcinoma (ESCC). We examined tissue specimens that had been removed from 90 patients with thoracic oesophageal cancer who had undergone surgery between 1983 and 2001. Immunohistochemical staining was performed by the standard streptavidin-biotin method. Immunostaining of TIMP-3 was seen in the cytoplasm of cancer cells and normal oesophageal epithelial cells, particularly in cells located in shallow areas of the tumour. TIMP-3 preserved (+), moderate (+/-), and reduced (-) cases accounted for 30, 27, and 33 of the 90 patients, respectively (33, 30, 37%). Significant correlations were observed between TIMP-3 expression and depth of tumour invasion (P=0.001), number of lymph node metastases (P=0.003), infiltrative growth pattern (P=0.003), and disease stage (P=0.005). The survival rates of patients with TIMP-3 (-) cancer were significantly lower than those of patients with TIMP-3 (+) and TIMP-3 (+/-) cancer (P=0.0003). The mean 5-year survival rates of patients with TIMP-3 (+), (+/-), and (-) were 50, 58, and 21%, respectively. In conclusion, decreased expression of TIMP-3 protein correlates with invasive activity and metastasis. This makes the prognosis for patients with cancer that has lost TIMP-3 significantly less favourable than that for patients with cancer that has maintained TIMP-3.

Adult↗

PubMed1997

Prognostic factors for surgical treatment of soft-tissue sarcomas in dogs: 75 cases (1986-1996).

OBJECTIVE: To determine results of surgery for treatment of soft-tissue sarcomas in dogs and to identify prognostic variables that can be used to predict outcome. DESIGN: Retrospective case series. ANIMALS: Dogs with soft-tissue sarcomas that had surgical treatment only. PROCEDURE: Records were examined for clinically relevant data. Histologic samples were reviewed. Follow-up information was obtained by physical examination or telephone conversations with referring veterinarians or owners. RESULTS: 75 dogs with soft-tissue sarcomas of the trunk and extremities were identified. Median age was 10.6 years. Malignant peripheral nerve sheath tumors were of a significantly lower grade than other tumors. Tumors recurred locally in 11 of 75 (15%) dogs. Evaluation for lack of tumor cells at surgical margins was prognostic for local recurrence. Metastatic disease developed in 13 of 75 (17%) dogs. Tumor mitotic rate was prognostic for development of metastasis. Twenty-five of 75 (33%) dogs died of tumor-related causes. Percentage of tumor necrosis and tumor mitotic rate were prognostic for survival time. Median survival time was 1,416 days. CLINICAL IMPLICATIONS: On the basis of a low local recurrence rate and high median survival time, wide excision of tumor margins or radical surgery appeared to be an effective means for managing soft-tissue sarcomas of the trunk and extremities. Analysis of histologic characteristics for prognosis supported use of preoperative biopsy. Surgical margins should be evaluated, and early use of aggressive surgery is indicated in the management of soft-tissue sarcomas in dogs.

Animals↗

PubMed1998

Superficial melanoma metastases: appearances on gray-scale and color Doppler sonography.

OBJECTIVE: The purpose of this study was to describe the sonographic appearances of melanoma metastases of the skin, subcutaneous tissues, and superficial lymph nodes. MATERIALS AND METHODS: Gray-scale sonography was performed on 31 superficial melanoma metastases in 18 patients. Discreteness of borders, contours, echogenicity, echotexture, and degree of acoustic through-transmission were evaluated for each lesion. Color Doppler sonography was also performed on 25 of the 31 lesions, by which the amount of internal color flow was qualitatively assessed. RESULTS: Twenty-eight (90%) of the 31 metastases had well-defined borders. Contours were smooth in 17 (55%), lobulated in 12 (39%), and spiculated in two (6%). Nineteen metastases (61%) were hypoechoic to muscle, 10 (32%) were isoechoic, and two (6%) were hyperechoic. Echotexture was homogeneous in six lesions (19%), mildly heterogeneous in 13 (42%), moderately heterogeneous in 11 (35%), and markedly heterogeneous in one (3%). Twenty-two lesions (71%) showed enhanced acoustic through-transmission. Of the 25 melanoma metastases for which we performed color Doppler sonography, 18 (72%) had internal arterial color flow and seven (28%) did not. The flow was characterized as mild in 13 (72%) of 18, moderate in four (22%), and marked in one (6%). CONCLUSION: On sonography, superficial melanoma metastases typically are well-defined hypoechoic lesions with smooth or lobulated contours, mild to moderate heterogeneity, and enhanced acoustic through-transmission. Internal flow revealed by color Doppler sonography is present in many, but not all, superficial melanoma metastases.

Female↗