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Local anesthetic thoracoscopy for the diagnosis of metastatic pleural melanoma originated from oral malignant melanoma: case report and comments.

Yang B, Li Q, Zhao H, Liu H, Tang T, Jiang C - World J Surg Oncol (2015)

Bottom Line: In this report, we presented a case of metastatic malignant melanoma of the pleura originated from OMM.The patient was therefore diagnosed with metastatic melanoma of the left pleura and the primary melanoma was OMM.According to this case, we could draw the conclusion that pleural metastasis from OMM was very rare and thoracoscopy preceded under local anesthesia is an important method for its accurate diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic Surgery, Tianjin Union Medicine Centre, 190 Jieyuan Road, Hongqiao District, Tianjin, 300121, People's Republic of China. ezxybj@sohu.com.

ABSTRACT

Background: Oral malignant melanoma (OMM) is an aggressive tumor with very low survival rate and easy to metastasize. Pleural metastatic melanoma via primary OMM is rare.

Case presentation: In this report, we presented a case of metastatic malignant melanoma of the pleura originated from OMM. A 54-year-old man without primary skin lesion was diagnosed multiple nodular shadows, pleural invasion, and pleural effusion by chest computed tomography (CT). One cyst-form tumor on the tongue base was observed by bronchoscopy, which was diagnosed as OMM by pathological examination and then was resected. After getting the tumor tissues from the pleura by pleural biopsy surgery, the diagnosis of pathological examination was pleural metastatic melanoma. Furthermore, tumor cells displayed a positive immunoreaction for melanocytic markers S100 and HMB-45 combining with positive vimentin and cytokeratin AE1/AE3. The patient was therefore diagnosed with metastatic melanoma of the left pleura and the primary melanoma was OMM.

Conclusions: According to this case, we could draw the conclusion that pleural metastasis from OMM was very rare and thoracoscopy preceded under local anesthesia is an important method for its accurate diagnosis.

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Related in: MedlinePlus

The chest CT imaging of the pleural effusion and lesions. Before operation, pleural effusion and lesions in the left thorax and multiple metastases in the right lung can be seen in CT scan imaging (a and b). After complete drainage of pleural effusion, metastatic neoplasms in pleura, enlargement of mediastinal lymph nodes, and lung metastases were clearly emerged by countercheck CT scan (c and d). The pleural lesions were pointed by blue arrows in d. a and c Lung window. b and d Mediastinum window
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Fig1: The chest CT imaging of the pleural effusion and lesions. Before operation, pleural effusion and lesions in the left thorax and multiple metastases in the right lung can be seen in CT scan imaging (a and b). After complete drainage of pleural effusion, metastatic neoplasms in pleura, enlargement of mediastinal lymph nodes, and lung metastases were clearly emerged by countercheck CT scan (c and d). The pleural lesions were pointed by blue arrows in d. a and c Lung window. b and d Mediastinum window

Mentions: The patient was a 54-year-old Han Chinese man who, in June 2013, was diagnosed as double-sided pleural effusion which was combined with the left multifocal pleural lesions and multiple lung metastases in the right lung by CT scan (Fig. 1a, b). The previous medical history reported no primary skin lesion including melanin stain. The related examines were finished before thoracoscopy pleural biopsy operation. One cyst of the neoplasm on the left side of the tongue base and multiple bronchial stenosis of left pulmonary segments were observed by narrow band imaging (NBI) bronchoscopy (Olympus, EVIS LUCERA) (Fig. 2). The tumor was then resected and diagnosed as OMM by pathological examination (Fig. 3a) and the immunohistochemical staining results (Additional file 1: Figure S1). The results of tuberculosis antibody (TB-Ab) and TB-DNA in serum were all negative. Serum tumor markers for lung carcinoma including carcino-embryonic antigen, carbohydrate antigen 72-4, squamous cell carcinoma, cyfra 21-1, cytokeratin 19 fragments, and ferritin were all in normal range. However, carbohydrate antigen 125 and neuron-specific enolase were about three times and two times higher than the upper limits, respectively.Fig. 1


Local anesthetic thoracoscopy for the diagnosis of metastatic pleural melanoma originated from oral malignant melanoma: case report and comments.

Yang B, Li Q, Zhao H, Liu H, Tang T, Jiang C - World J Surg Oncol (2015)

The chest CT imaging of the pleural effusion and lesions. Before operation, pleural effusion and lesions in the left thorax and multiple metastases in the right lung can be seen in CT scan imaging (a and b). After complete drainage of pleural effusion, metastatic neoplasms in pleura, enlargement of mediastinal lymph nodes, and lung metastases were clearly emerged by countercheck CT scan (c and d). The pleural lesions were pointed by blue arrows in d. a and c Lung window. b and d Mediastinum window
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4666196&req=5

Fig1: The chest CT imaging of the pleural effusion and lesions. Before operation, pleural effusion and lesions in the left thorax and multiple metastases in the right lung can be seen in CT scan imaging (a and b). After complete drainage of pleural effusion, metastatic neoplasms in pleura, enlargement of mediastinal lymph nodes, and lung metastases were clearly emerged by countercheck CT scan (c and d). The pleural lesions were pointed by blue arrows in d. a and c Lung window. b and d Mediastinum window
Mentions: The patient was a 54-year-old Han Chinese man who, in June 2013, was diagnosed as double-sided pleural effusion which was combined with the left multifocal pleural lesions and multiple lung metastases in the right lung by CT scan (Fig. 1a, b). The previous medical history reported no primary skin lesion including melanin stain. The related examines were finished before thoracoscopy pleural biopsy operation. One cyst of the neoplasm on the left side of the tongue base and multiple bronchial stenosis of left pulmonary segments were observed by narrow band imaging (NBI) bronchoscopy (Olympus, EVIS LUCERA) (Fig. 2). The tumor was then resected and diagnosed as OMM by pathological examination (Fig. 3a) and the immunohistochemical staining results (Additional file 1: Figure S1). The results of tuberculosis antibody (TB-Ab) and TB-DNA in serum were all negative. Serum tumor markers for lung carcinoma including carcino-embryonic antigen, carbohydrate antigen 72-4, squamous cell carcinoma, cyfra 21-1, cytokeratin 19 fragments, and ferritin were all in normal range. However, carbohydrate antigen 125 and neuron-specific enolase were about three times and two times higher than the upper limits, respectively.Fig. 1

Bottom Line: In this report, we presented a case of metastatic malignant melanoma of the pleura originated from OMM.The patient was therefore diagnosed with metastatic melanoma of the left pleura and the primary melanoma was OMM.According to this case, we could draw the conclusion that pleural metastasis from OMM was very rare and thoracoscopy preceded under local anesthesia is an important method for its accurate diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic Surgery, Tianjin Union Medicine Centre, 190 Jieyuan Road, Hongqiao District, Tianjin, 300121, People's Republic of China. ezxybj@sohu.com.

ABSTRACT

Background: Oral malignant melanoma (OMM) is an aggressive tumor with very low survival rate and easy to metastasize. Pleural metastatic melanoma via primary OMM is rare.

Case presentation: In this report, we presented a case of metastatic malignant melanoma of the pleura originated from OMM. A 54-year-old man without primary skin lesion was diagnosed multiple nodular shadows, pleural invasion, and pleural effusion by chest computed tomography (CT). One cyst-form tumor on the tongue base was observed by bronchoscopy, which was diagnosed as OMM by pathological examination and then was resected. After getting the tumor tissues from the pleura by pleural biopsy surgery, the diagnosis of pathological examination was pleural metastatic melanoma. Furthermore, tumor cells displayed a positive immunoreaction for melanocytic markers S100 and HMB-45 combining with positive vimentin and cytokeratin AE1/AE3. The patient was therefore diagnosed with metastatic melanoma of the left pleura and the primary melanoma was OMM.

Conclusions: According to this case, we could draw the conclusion that pleural metastasis from OMM was very rare and thoracoscopy preceded under local anesthesia is an important method for its accurate diagnosis.

Show MeSH
Related in: MedlinePlus