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[en] The hypoxic cell sensitizer Ro 03-8799 has been given with radiotherapy to achieve complete and sustained regression in 5 of 7 cases of recurrent malignant melanoma treated with the object of cure and in 1 of 3 treated palliatively. Particularly high tumour concentrations of this radiosensitizing drug have been found in 3 of 6 cases studied. 9 refs.; 2 figs.; 2 tabs
[en] Melanoma is the most malignant cutaneous tumor. In the present time, sentinel node biopsy is a standard of care in patients with thickness of primary lesion more than 1 mm. Authors present a case report of a patient after excision of cutaneuos tumor from the right shoulder which was initially histopathologically diagnosed as melanoma in situ. This patient developed after eight years regional supraclavicular and axillary lymphadenopathy, and therefore the histopathological examination of the specimen was revised. This revision classified the primary tumor as a superficial spreading melanoma Breslow 0.9 mm, Clark III with mitotic rate of 5 mitoses/1 mm2. On the basis of the histopathologic finding of metastatic involvement of the supraclavicular lymph node a complete dissection of the right axillary lymph nodes was performed. Metastases were present in all dissected axillary lymph nodes. Authors discuss individual consideration for offering sentinel node biopsy to patients with melanoma of thickness less than 1 mm if risk factors such as mitotic rate equal to or more than 1 mitosis/1 mm2 and ulceration are present. (author)
[en] Choroidal malignant melanomas are relatively rare tumours and can have a very long natural history. The management of these tumours is controversial. The results of a study of a small group of patients treated by radiotherapy, either as primary treatment or following local excision or enucleation, are presented here. The value of radical radiotherapy in the management of choroidal malignant melanoma is discussed. (author)
[en] Introduction: The therapeutic landscape of metastatic melanoma drastically changed after the introduction of targeted therapies and immunotherapy, in particular immune checkpoints inhibitors (ICI). In recent years, positive effects on the immune system associated to radiotherapy (RT) were discovered, and radiation has been tested in combination with ICI in both pre-clinical and clinical studies (many of them still ongoing). We here summarize the rationale and the preliminary clinical results of this approach. Materials and methods: In the first part of this review article, redacted with narrative non-systematic methodology, we describe the clinical results of immune checkpoints blockade in melanoma as well as the biological basis for the combination of ICI with RT; in the second part, we systematically review scientific publications reporting on the clinical results of the combination of ICI and RT for advanced melanoma. Results: The biological and mechanistic rationale behind the combination of ICI and radiation is well supported by several preclinical findings. Retrospective observational series and few prospective trials support the potential synergistic effect between radiation and ICI for metastatic melanoma. Conclusion: RT may potentiate anti-melanoma activity of ICI by enhancing response on both target and non-target lesions. Several prospective trials are ongoing with the aim of further exploring this combination in the clinical setting, hopefully confirming initial observations and opening a new therapeutic window for advanced melanoma patients.
[en] Primay melanoma of the cavernous sinus is very rare with only few cases reported in the literature. We present the cross-sectional imaging findings of this rare tumor. The differential diagnosis for cavernous sinus mass lesion is wide as it contains vital neurovascular structures that may be affected by vascular, neoplastic, infective, and infiltrative lesions arising in the cavernous sinus proper or via extension from adjacent intra and/or extracranial regions. Radiologic imaging can narrow the differential diagnosis, however, imaging cannot definitely reach single diagnosis if they present in atypical form with hemorrage and cystic degeneration. This case report illustrates that primary cavernous sinus melanoma may present as a atypical tumor with diagnostic dilemma.
[en] Fraction size in radiotherapy of malignant melanoma remains a point of controversy. Among 139 patients treated at the University of Illinois Hospital in 1979-1988, 36 were considered potentially curable (not counting ocular melanomas); 20 were treated by the Princess Margaret Hospital (PMH) hypofractionated schedule using 800 cGy per fraction and achieved a permanency of local control lasting > 6 months since the beginning of radiotherapy in 10/22 (45.5%) courses. Comparable results were obtained in 11 patients treated by standard fractionation to at least threshold curative levels. A modification of PMH regimen in 5 patients (but with 13 courses) by decreasing fraction size to 400 cGy while keeping total dose and course duration unchanged, resulted in a 100% loss of focal control within 6 months. Patients considered incurable and irradiated by PMH schedule responded in 83% of courses compared to 51.4% response rate in patients irradiated with other schedules (except) modified PMH regimen). Other aspects of melanoma management are analyzed. (author) 12 tabs., 3 figs., 32 refs
[en] MRI of uveal melanoma using 1.5-T technology and surface coils has developed into a standard procedure. The purpose of the study was to evaluate the feasibility of 3.0-T technology in eye imaging. To optimize the MRI sequences for clinical eye imaging with 3.0-T, six healthy volunteers were conducted using a 4.0-cm surface coil. Evaluation criteria were the signal-to-noise-ratio (SNR), contrast-to-noise-ratio (CNR) and image quality. A further six patients with uveal melanoma were examined with 1.5- and 3.0-T under retrobulbar anesthesia. During 3.0-T examinations of volunteers, eye movements caused significant artifacts. On the contrary, excellent imaging quality was reached in examinations of patients under retrobulbar anesthesia at 3.0 T. Subjective assessment showed no significant difference between 1.5 and 3.0 T in patients. Due to the increased SNR, the 3.0-T technique has the potential to improve eye imaging, but the higher susceptibility to motion artifacts limits the clinical use of this technique to patients receiving retrobulbar anesthesia. (orig.)