The prognostic implications of location for scalp melanoma

Article Abstract:

Malignant melanoma is a tumor, usually involving the skin, that contains melanocytes (cells that produce melanin, the black or brown pigment that occurs naturally in the skin, hair, and iris). Anatomic location is important in predicting survival, especially among patients with head and neck melanoma; patients with melanoma of the scalp have poorer five-year survival rate than those with melanoma of the face. The term 'scalp' implies the area of the head covered by the hair; however, the anatomic scalp, characterized by tissue well supplied with blood and lymphatic vessels, actually extends to the supraorbital right (area of the eyebrows) and includes a large non-hair bearing area. A review was undertaken of 95 patients with primary malignant melanoma to determine the influence of location on the outcome of scalp melanoma. Melanoma recurrence and survival studies were carried out; 91 of the 95 patients were able to be followed-up. There was an equal distribution of tumors in the hair-bearing and non-hair-bearing areas of the scalp. Types of treatment were similar and equally distributed between patients with lesions in hair-bearing areas and those with lesions in non-hair-bearing areas of the scalp. The overall melanoma-specific five-year survival rate was 65 percent. For patients with lesions in non-hair-bearing areas, five-year survival was 86 percent; for patients with lesions in hair-bearing areas of the scalp, five-year survival was 47 percent. It is suggested that by using the anatomic definition of scalp, analysis of specific factors influencing prognosis may be undertaken; thus, comparison may be made of lesions with similar lymphatic and vascular supplies. (Consumer Summary produced by Reliance Medical Information, Inc.)

Patient outcomes, Mortality, Prognosis, Melanoma, Head and neck cancer

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Vascular lesions of the intestines

Article Abstract:

The pathology, abnormal physiology, diagnosis and treatment of vascular lesions of the intestine that cause gastrointestinal (GI) bleeding are reviewed. About 90 percent of all cases of upper GI bleeding are due to duodenal ulcer, gastritis, or esophageal varices (twisted veins in the esophagus). In elderly patients a significant percent of acute lower GI bleeding is due to vascular lesions; this is especially true in patients with chronic or occult intestinal blood loss. There are various types of vascular lesions; benign (such as telangiectasis, permanent dilation of superficial vessels); hemangiomas (benign tumors consisting of blood vessels); and malignant lesions (such as angiosarcoma or hemangioendothelioma). Diagnosis of intestinal vascular lesions can be done by surgical operation, observation, angiography (X-ray visualization of the vessel) or endoscopy (visualization of the interior of the intestine using an illuminated, fiberoptic instrument). Treatment is dependent on the type and location of the lesion, as well as whether other areas are involved, how severe the symptoms are, and whether it is possible to surgically remove the lesions. Colon lesions can be treated surgically, if they are limited to the colon. The most difficult to treat are multiple lesions that involve the entire gastrointestinal tract. In the author's personal experience over 18 years he has evaluated over 200 patients with chronic blood loss that had been difficult to detect. Ultimately about 90 percent of patients were eventually diagnosed, and 72 patients underwent surgery to control the bleeding. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Causes of, Gastrointestinal bleeding, Gastrointestinal hemorrhage, Surgery, Intestines, Blood vessels, Arteriovenous malformations, Cardiovascular tumors, Vascular tissue tumors

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