Malignant blue nevus

Article Abstract:

Nevi are popularly referred to as moles. Pigmented cells within a nevus contain varying amounts of the black pigment melanin, which accounts for their brown or black coloration. Blue nevi have a blue to black appearance. Blue nevi contain the same black pigment, but their apparent color comes from their location within the skin: blue nevi are deeper in the dermis of the skin. The upper portion of the dermis and the overlying epidermis are not included in the blue nevus. Melanoma, a particularly malignant form of skin cancer, generally arises from atypical moles. It is rare, however, for a blue mole to undergo malignant transformation to melanoma. Since melanoma arising from blue nevi is so rare, most of the data on these cancers in the medical literature is in the form of a case study or, at best, a study of a small number of patients. To obtain more data on the malignant blue nevus, the authors reviewed patient records at their institution and identified 24 cases. However, in only 16 of these cases were microscopic slides available for review. The authors carefully confirmed the original diagnosis, and in only 12 cases was there sufficient data to state with confidence that the malignancy did, indeed, arise from a blue nevus. In two cases, the blue nevus was present at birth, and in one case the nevus arose during childhood. In the remaining cases, the blue nevi were first noted in adulthood. The data indicate that when the blue nevus does become malignant, the resulting cancer is especially aggressive. Of the 12 patients, follow-up was available for 11. Ten of these 11 developed metastatic spread of their cancer. The authors attribute previous suggestions that malignant blue nevus is not as malignant as melanoma to a failure to properly interpret some histological features of biopsy specimens. Of the 11 patients for whom follow- up information is available, eight are dead, and only one of the surviving patients is free from signs of metastatic disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Mole (Dermatology), Nevus

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Diffuse leiomyosarcomatosis of the colon

Article Abstract:

Leiomyosarcomas, or smooth muscle tumors, are extremely rare in the colon. In one case, a 30-year-old man had experienced ulcerative colitis for five years. Repeated colonoscopies were negative, but bleeding episodes required that yet another colonoscopy be performed. Pseudopolyps were found in the rectum, some large polypous tumors were found at 10 centimeters, and at 40 centimeters the colon was found to be obstructed by tumor growth. A colonectomy (removal of the colon) was performed, and over 50 soft polypous tumors were discovered in the surgical specimen. Microscopic examination revealed the tumors to be leiomyosarcomas. The previously reported cases all involved single tumors, yet in this case the smooth muscle tumor was diffuse and affected a great length of the large bowel. Patients with colitis are known to be at higher risk for developing colon cancer, but this is the first case in which colitis has been associated with smooth muscle tumors. It is possible that in this case the leiomyosarcomas were a consequence of the inflammatory bowel disease, or the anti-inflammatory therapy, or both. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Colorectal cancer, Ulcerative colitis, Leiomyosarcoma

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A rapidly growing pigmented nail streak resulting in diffuse melanosis of the nail: a possible sign of subungual melanoma in situ

Article Abstract:

Melanoma, cancer of melanocytes which are pigment carrying cells of the skin, occurs less frequently among Japanese people than in whites. Subungual melanoma develops under a nail and is one of the most common type of malignant melanoma in Japanese adults, but is rare in children. Most pigmented nail streaks are benign and seldom develop into subungual melanoma. However, rapidly growing pigmented nail streaks are thought to be an early stage of subungual melanoma. Four patients, including three children, with rapidly growing pigmented nail streaks are described. The tissues in two of the cases had a combination of colors, ranging from dark brown to black, which is characteristic of subungual melanoma. The tissues in the other two cases contained many fine dark lines with light brown pigmentation. Microscopic examination of the tissues revealed large numbers of melanocytes which contained vacuoles and atypical nuclei. These histologic changes indicate atypical melanocytic hyperplasia, or abnormal proliferation of melanocytes or intraepidermal melanoma, which is a early lesion of subungual melanoma. (Consumer Summary produced by Reliance Medical Information, Inc.)

Japan, Cancer

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