MELANOMA IN THE CLINIC – DIAGNOSIS, MANAGEMENT AND COMPLICATIONS OF MALIGNANCY Edited by Mandi Murph Melanoma in the Clinic – Diagnosis, Management and Complications of Malignancy Edited by Mandi Murph Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2011 InTech All chapters are Open Access articles distributed under the Creative Commons Non Commercial Share Alike Attribution 3.0 license, which permits to copy, distribute, transmit, and adapt the work in any medium, so long as the original work is properly cited. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published articles. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Petra Nenadic Technical Editor Teodora Smiljanic Cover Designer Jan Hyrat Image Copyright Andresr, 2010. Used under license from Shutterstock.com First published July, 2011 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Melanoma in the Clinic – Diagnosis, Management and Complications of Malignancy, Edited by Mandi Murph p. cm. ISBN 978-953-307-571-6 free online editions of InTech Books and Journals can be found at www.intechopen.com Contents Preface IX Part 1 Melanoma Models and Diagnostic Techniques 1 Chapter 1 Acral Melanoma: Clinical, Biologic and Molecular Genetic Characteristics 3 Minoru Takata Chapter 2 Histopathological Diagnosis of Early Stage of Malignant Melanoma 15 Eiichi Arai, Lin Jin, Koji Nagata and Michio Shimizu Chapter 3 Wnt/β-Catenin Signaling Pathway in Canine Skin Melanoma and a Possibility as a Cancer Model for Human Skin Melanoma 23 Jae-Ik Han and Ki-Jeong Na Chapter 4 Improving Diagnosis by Using Computerized Citometry 41 Valcinir Bedin Chapter 5 Modern Techniques for Computer-Aided Melanoma Diagnosis 63 Maciej Ogorzałek, Leszek Nowak, Grzegorz Surówka and Ana Alekseenko Chapter 6 Investigation of Relations Between Skin Cancer Lesions‘ Images and Their Reflectance and Fluorescent Spectra 87 Petya Pavlova, Ekaterina Borisova, Lachezar Avramov, Elmira Petkova and Petranka Troyanova Part 2 Immunology and the Association with Melanoma 105 Chapter 7 Co-operation of Innate and Acquired Immunity for Controlling Tumor Cells 107 Hidemi Takahashi VI Contents Chapter 8 Adoptive T-Cell Therapy of Melanoma: Promises and Challenges 115 Patrick Schmidt and Hinrich Abken Chapter 9 Current Perspectives on Immunomodulation of NK Cells in Melanoma 133 Tadepally Lakshmikanth and Maria H. Johansson Chapter 10 Tumour-Associated Macrophages (TAMs) and Cox-2 Expression in Canine Melanocytic Lesions 163 Isabel Pires, Justina Prada, LuisCoelho, Anabela Garcia and Felisbina Luisa Queiroga Part 3 Disease Management and Clinical Cases 181 Chapter 11 Surgical Management of Malignant Melanoma of Gastrointestinal Tract 183 Thawatchai Akaraviputh and Atthaphorn Trakarnsanga Chapter 12 Surgical Treatment of Pulmonary Metastases from Melanoma: Emerging Options 201 Pier Luigi Filosso, Alberto Sandri, Enrico Ruffini, Paolo Olivo Lausi, Maria Cristina Bruna and Alberto Oliaro Chapter 13 Melanoma-Predisposing CDKN2A Mutations in Association with Breast Cancer: A Case-Study and Review of the Literature 211 Klára Balogh, Edina Nemes, Gabriella Uhercsák, Zsuzsanna Kahán, György Lázár, Gyula Farkas, Hilda Polyánka, Erika Kiss, Rolland Gyulai, Erika Varga, Erika Keresztné Határvölgyi, László Kaizer, Lajos Haracska, László Tiszlavicz, Lajos Kemény, Judit Oláh and Márta Széll Chapter 14 The Biology and Clinical Relevance of Sentinel Lymph Nodes in Melanoma 225 Brian Parrett, Lilly Fadaki, Jennifer Y. Rhee and Stanley P.L. Leong Part 4 Melanoma Complications and Rare Types of Disease 239 Chapter 15 Melanoma and Pregnancy 241 C. Pagès and M. Viguier Chapter 16 Malignant Melanoma in Genito-Urinary Tract 265 Abdulkadir Tepeler, Mehmet Remzi Erdem, Sinasi Yavuz Onol, Abdullah Armagan and Alpaslan Akbas Chapter 17 The Stage of Melanogenesis in Amelanotic Melanoma 277 Naoki Oiso and Akira Kawada Contents VII Chapter 18 The Interaction Between Melanoma and Psychiatric Disorder 287 Steve Kisely, David Lawrence, Gill Kelly, Joanne Pais and Elizabeth Crowe Preface Melanoma Oncologists who have in the past struggled with resolving how best to treat their patients given the few effective therapeutics available are now beginning to con- front the disease directly. These new tools are likely to change clinical practice sur- rounding melanoma. In the first section of this book, several manuscripts discuss imaging techniques for di- agnosis – currently the best way to cure melanoma early before it develops into a late ‐ stage, metastatic disease. Further, this book discusses the clinical aspects of melanoma treatment in surgery and long‐term management. Acral, cutaneous and mucosal mel- anomas are represented in this book, along with some rather unusual clinical observa- tions. As such, it provides insight into rare case studies only observed by a few clini- cians. When most people consider melanoma, it is likely to be regarded as cutaneous melanoma derived by overexposure to a lifetime of UV radiation. In contrast, manu- scripts presented here discuss melanoma in the gastrointestinal tract, genito‐urinary tract, female genital tract, pulmonary metastases, familial mutations leading to mela- noma, canine melanoma and melanoma in pregnancy. It is a fascinating representa- tion of the diversity of clinical cases that exist globally. Again, I have to thank several outstanding people, without whom this would not have otherwise been possible – Ana Pantar, Petra Nenadic, Juliet Eneh and Molly Altman. These people helped me throughout this process. In addition, I would also like to thank my loving spouse, Gary Rollie, who is always a supportive champion of my career. This past year he listened to me say that, “This will only take a few more minutes,” knowing that it wasn’t true, but understanding that at some point I would finish. And I did. I hope you enjoy reading this book as much as I did. Sincerely, Mandi Murph, Ph.D. Assistant Professor Department of Pharmaceutical and Biomedical Sciences University of Georgia College of Pharmacy Athens, GA, USA [...]... Useful findings of immunostaining Regarding the immunohistochemistry in the diagnosis of MM, combined immunohistochemical stains may be used to gain useful information in the diagnosis of early stage of MM In Spitz nevus, nevoid nevus, blue nevus, melanocytic nevus and normal 20 Melanoma in the Clinic – Diagnosis, Management and Complications of Malignancy Fig 9 Spitzoid melanoma (low power view): There... (Curtin et al., 2005) (Curtin et al., 2005) (Curtin et al., 2006) (Sauter et al., 2002) (Chernoff et al., 2009) including one melanoma on face Table 2 Comparison of somatic genetic changes between acral melanomas and melanomas from intermittently sun-exposed skin 8 Melanoma in the Clinic – Diagnosis, Management and Complications of Malignancy Cyclin D1 positively regulates the activity of cyclin dependent... processes including the formation of neural crest-derived melanocytes (Larue & Delmas 2006) In neural-crest 26 Melanoma in the Clinic – Diagnosis, Management and Complications of Malignancy Fig 1 Regulation of Wnt/β-catenin signaling pathway In the absence of Wnt signals, the cellular concentration of free β-catenin is low, because a complex of the adenomatous polyposis coli (APC), glycogen synthase kinase... through the interaction with separate domains of Axin (Kimelman & Xu, 2006) After then, the E3 ubiquitin ligase β-Trcp binds to serine 33 and 37 of β-catenin, and leads to β-catenin ubiquitination and degradation GSK3 and CK1 also phosphorylate Axin and Adenomatous polyposis coli (APC), resulting in the enhancement of β-catenin phosphorylation and degradation through increased association between Axin/APC... Macroscopically, 16 Melanoma in the Clinic – Diagnosis, Management and Complications of Malignancy changes of asymmetry, border irregularity, color variation in the ABCDE rule and dermoscopically irregular reticular pigment network are important findings for their diagnosis Histologically, in typical LMs, three of the diagnostic clues of MM in situ described above are used for the diagnosis of LM In the early... The nuclei are larger than those of normal melanocytes, show hyperchromatic nuclei, and have large nucleoli (Fig 6) These findings are reported in our report9) 18 Melanoma in the Clinic – Diagnosis, Management and Complications of Malignancy Fig 4 How to cut the specimen of pigmented lesion on the volar skin Lesions should be cut perpendicularly for cutaneous secant (the direction of skin crista and. .. 2, Bethesda, Maryland, 2010 22 Melanoma in the Clinic – Diagnosis, Management and Complications of Malignancy [2] Weedon D: Weedon’s Skin Pathology, 3rd ed, Churchill Livingstone Elsevier, 2010 [3] Massi G and LeBiot PE: Histological Diagnosis of nevi and Melanoma, Steinkopff Darmstadt Springer, Germany, 2004 [4] King R et al: Lentiginous melanoma: a histologic pattern to melanoma to be distinguished... observation of melanocytes on the crista profunda intermedia as pointed out by Ishihara et al8), we found important findings about the distribution pattern and cytological atypia In the early lesion, the melanocytes on the slope of rete ridges on the crista profunda intermedia exist without a continuous pattern, showing irregular intervals of each melanocyte and loss of polarity of nuclei against the basement... 2008) 2 Axin concentration is different among each component in Xenopus, indicating that Axin controls the rate of the complex assembly (Lee et al., 2003) However, it is not sure whether the different concentration of Axin in each component is universal to other organisms APC is a part of the Axin complex causing β-catenin phosphorylation APC also inhibit the dephosphorylation of β-catenin, and thereby... the importance of proper patient selection (Ugurel et al., 2005; Wyman et al., 2006; Kim et al., 2008) There are currently three ongoing clinical trials 10 Melanoma in the Clinic – Diagnosis, Management and Complications of Malignancy prospectively testing imatinib in selected patients with melanoma showing KIT mutations or amplifications (mostly acral and mucosal melanomas)(Table 3) The NCT00470470 . MELANOMA IN THE CLINIC – DIAGNOSIS, MANAGEMENT AND COMPLICATIONS OF MALIGNANCY Edited by Mandi Murph Melanoma in the Clinic – Diagnosis, Management and Complications. Melanoma in the Clinic – Diagnosis, Management and Complications of Malignancy 8 Cyclin D1 positively regulates the activity of cyclin dependent kinases, leading to phosphorylation of retinoblastoma. irregular lines on a b a c d Melanoma in the Clinic – Diagnosis, Management and Complications of Malignancy 6 brown background, pigmentation of the cuticle (micro-Hutchingson’s sign),