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PubMed2002

Peritoneal melanosis combined with serous cystadenoma of the ovary: a case report and literature review.

Benign peritoneal melanosis is extremely rare and traditionally occurs in association with ovarian dermoid cysts, but rarely with peritoneal cyst, enteric duplication cyst or gastric triplication. The pathogenesis of peritoneal melanosis, in particular, the origin of the pigment-producing cells is unclear. We describe a case of peritoneal melanosis that was associated with ovarian serous cystadenoma in a young woman. Ovarian serous cystadenoma has not been previously described as a combined lesion of peritoneal melanosis. Based on the extremely rare incidence of this lesion and heterogeneous combined lesions, the possibility of an incidentally found, coexisting lesion couldn't be excluded. Here, we suggest that peritoneal mesothelial cells pinched off during the developmental period might be a source of pigment-producing cells.

Adult↗
PubMed2001

[The treatment of a primary acquired melanosis of the conjunctiva with atypia by low dose of Mitomycin C 0.02 % - case report with follow up of 2 years].

BACKGROUND: About 70 % of the melanomas of the conjunctiva develop from an primary acquired melanosis (PAM) with atypia. This is the reason why excision, radiation, cryotherapy or a combination of them are proposed for therapy. But, if the acquired melanosis is very large, serious complications will be found with that treatment. PATIENT AND METHOD: A 65-year-old woman has shown a large melanosis of the conjunctiva of her left eye. Biopsies, taken from different sites of the conjunctiva, have confirmed the diagnosis of an acquired melanosis of the conjunctiva with atypia. This has been the reason for our Mitomycin C 0.02 % therapy for one week. It has been repeated once again after half a year. RESULTS: Atypia of the cells was shown in the upper cell layer of the conjunctiva after the first therapy. But after the second therapy no atypia of the cells was present within two years after the last treatment, examining several biopses. CONCLUSION: Looking for an effective treatment without complications, a new therapy with Mitomycin C has been introduced in the last years. As it is not yet clearly known how to use Mitomycin to have maximal effectiveness with minimal complications, the reports about doses and frequency are differing a lot in the literature and are more often considerably lying over the introduced effective dose of our case. If Mitomycin is used in that low dosage and in that special application as shown, it could be a very efficient therapy with less complications.

Administration, Topical↗
PubMed1998

Nodular melanosis due to epithelial neoplasms: a finding not restricted to regressed melanomas.

Nodular or tumoral melanosis consists of nodular or sheetlike deposits of melanophages in the dermis. When nodular melanosis is present, a completely regressed malignant melanoma is a major diagnostic consideration. We present a case of nodular melanosis due to regression of a pigmented basal cell carcinoma with pilar differentiation. In addition to this case, we present five additional cases of epithelial neoplasms with melanin deposition in the stroma. In each case, the source of the melanin was non-neoplastic dendritic melanocytes intermingled among the tumor cells. Therefore, if nodular melanosis is found, pigmented epithelial neoplasms should also be considered in the differential diagnosis.

Aged↗
PubMed1999

Melanosis in association with metastatic malignant melanoma: report of a case and a unifying concept of pathogenesis.

An unusual case of melanosis associated with metastatic malignant melanoma is reported. This was characterized by progressive blue/gray discoloration of the skin of the chest and abdomen in an elderly patient, 1 year after removal of a polypoid malignant melanoma from the right arm. A biopsy of involved skin revealed perivascular aggregates of melanin-laden histiocytes throughout the dermis, the histopathologic hallmark of melanosis. An unusual aspect of the case was the coincidental finding of a tumor embolus within a small dermal vessel, probably a lymphatic. To date, neoplastic melanocytes have been detected in only a small minority of skin biopsies with features of melanosis. This case and a distillation of related information in the literature lead to the conclusion that the essence of melanosis, and the feature that distinguishes this from conventional metastatic melanoma, is the persistent and cumulative dissemination of melanin, via the bloodstream, throughout the body. This in turn leads to progressive pigmentation of all internal organs and the skin. Only continuous access to the circulation by neoplastic melanocytes could explain such a phenomenon. Potential mechanisms by which this could arise are discussed in the context of existing knowledge.

Aged↗
PubMed1998

Melanosis coli in inflammatory bowel disease.

Melanosis coli is a relatively common condition in which pigment is deposited in macrophages in the colonic lamina propria. The association with anthraquinone laxatives is well described, but melanosis coli has also been described in patients not using these agents. We report 25 patients with inflammatory bowel disease and melanosis coli, 5 (20%) of whom had documented laxative use. Most patients had ulcerative colitis (72%) or Crohn's colitis (24%), and the mean duration of inflammatory bowel disease was more than 7 years. These data raise the possibility that chronic colitis could cause melanosis coli even in the absence of laxative use.

Adolescent↗
PubMed2003

Coexistence of Riehl's melanosis and lichen planus.

A 61-year-old man presented with purple-red papules and plaques. These lesions on the nape and dorsal aspects of both hands displayed the histological findings characteristic of lichen planus. Riehl's melanosis, which is synonymous with pigmented contact dermatitis, was present on the forehead and bald scalp. Riehl's melanosis typically appears on the face and is induced by cosmetics. Causative factors in this case, however, remained undefined. The coexistence of lichen planus and Riehl's melanosis at separate sites in a single patient suggests that the two diseases represent manifestations of specific immune responses characteristic of lichenoid tissue reaction and situate in the same spectrum. The differences in the skin manifestations of lichen planus and Riehl's melanosis might depend on the severity of immune responses against intrinsic or extrinsic antigens. In addition, the skin manifestations of lichenoid tissue reaction might depend on the disposition of the lesion sites.

Humans↗
PubMed2001

Colonic lymphoid hyperplasia in melanosis coli.

We describe the case of a patient with Rett syndrome, a syndrome characterized by progressive infant encephalopathy, developmental delay, dementia, autism, ataxia, microcephaly, spastic paraparesis, and autonomic neuropathy with constipation. At colonoscopy, multiple foci of tiny white, sessile, polypoid lesions were seen throughout the colon and rectum, mimicking the appearances of small hyperplastic or adenomatous polyps, associated with generalized melanosis coli. This is the first case to our knowledge describing melanosis coli in a patient with Rett syndrome. As melanosis pigment deposition is characteristically not seen in lymphoid tissue, the lymphoid tissue was identifiable at endoscopy as multiple white nodules mimicking generalized colonic polyposis throughout the colon. We discuss the likely mechanisms of lymphoid hyperplasia and coexistent melanosis coli in Rett syndrome.

Abdominal Pain↗
PubMed2001

Melanosis of the vagina. A case report.

BACKGROUND: Melanosis is a term given to lesions in which melanin pigment is confined to the basal layer of squamous epithelium and on visual inspection may have an appearance similar to that of malignant melanoma. Although relatively common in the oral and gastrointestinal tract, melanosis is an uncommon finding in the female genital tract and especially rare in the vagina; most reported cases have been vulvar. CASE: A 43-year-old, nulliparous woman was noted to have a pigmented lesion at the vaginal cuff during a routine annual examination one year after a hysterectomy. On physical examination, the lesion appeared as a coalescence of several small, pigmented areas at the cuff. On palpation the lesion was flat, having the contour of normal vaginal mucosa, and was not indurated or tender. A biopsy revealed vaginal melanosis. The patient was followed conservatively, with annual examinations, which documented no change in color, size or contour of the lesion. At this writing the patient is six years from presentation and doing well. CONCLUSION: Vaginal melanosis may be difficult to distinguish clinically from malignant melanoma but carries a much different prognosis. A biopsy of any pigmented lesion is always indicated prior to determining the need for therapy versus observation.

Adult↗
PubMedDate not supplied

[The association of primary acquired conjunctival melanosis, malignant melanoma and Parinaud's dermoepithelioma].

The association of a primary acquired conjunctival melanosis, a malignant conjunctival melanosis, and a nevus cysticus, has never been reported in the literature, as far as we know. If the coexistence of a malignant melanosis and a primary acquired melanosis may be explained easily, it is still difficult to construe the presence of a nevus cysticus, since it is usually a mild tumor, that does not degenerate.

Conjunctival Diseases↗
PubMed1979

Melanosis of the choroid plexus, ependyma, subependymal neuroglia, and dentate and trigeminal motor nuclei: observations on the choroidal and ependymal cilia.

Melanosis of the choroid plexus, ependyma, subependymal neuroglia of the fourth ventricle, and dentate and trigeminal motor nuclei was found in a 50-year-old man who died with cor pulmonale, hypertensive cardiovascular disease, and intracerebral hemorrhage. This case is the first known example of melanosis not associated with neurocutaneous melanosis to involve multiple structures of the brain. Nonenzymatic conversion of lipofuscin into melanin is suggested as the mechanism of the melanosis. Cilia of the choroidal epithelium and ependyma were identified in this case, despite a long delay in postmortem examination. These observations on choroidal epithelium confirm previous reports that the choroid plexus of man is ciliated, as in other mammals and lower vertebrates.

Brain Diseases, Metabolic↗
PubMed1995

Melanosis coli or mucosa ischemia? A case report.

The presence of a black or brown stoma may indicate a serious problem, such as a necrotic stoma, or may be the result of a benign pigmentation disorder known as melanosis coli. Melanosis coli is caused by anthraquinone laxative abuse and has no associated morbidity. The case report involves a 63 year old white female admitted to the hospital emergency room. Secondary to uterine choriocarcinoma, an end sigmoid colostomy was created. The mucosa was moist but black, despite the fact that the serosa had been pink and bled easily. Biopsy revealed neither necrotic stoma nor infarcted bowel but melanosis coli related to the patient's 20 year history of laxative use for chronic constipation. Melanosis coli does not require medical or surgical intervention and is considered a benign pigmentation disorder. However, knowledge of this condition and of the bowel patterns and habits of patients prior to their ostomy surgery, is essential to establishing the differential diagnosis for a brown or black stoma.

Anthraquinones↗
PubMed1998

[Neurocutaneous melanosis].

INTRODUCTION: Neurocutaneous melanosis is an infrequent condition characterized by the presence of numerous gigantic cutaneous naevi and melanocytic infiltration of the central nervous system and/or the leptomeningeal layers. Different clinical features may be seen: endocranial hypertension due to hydrocephalus, cranial nerve paralysis, myelopathy, convulsive seizures, etc. The prognosis is considered to be malignant. Only positive CNS histological findings confirm the diagnosis. CLINICAL CASE: We present the case of a man with cutaneous lesions compatible with the diagnosis of neurocutaneous melanosis since birth, with benign self-limiting epilepsy in early childhood. Cerebral CT and MR scans were normal until the age of 17, when hipper-signal lesions appeared on MR, infiltrating the leptomeninges of the deep temporal pole and anterior aspect of the cerebral peduncles, which suggested the presence of melanocytes in the CNS. CONCLUSIONS: There are cases of neurocutaneous melanosis with a good medium-term prognosis and benign manifestations until infiltration of the CNS occurs. Then they start to show the classical behavior of cases with a malignant prognosis. MR should be included as part of the diagnostic criteria for neurocutaneous melanosis. MR should be done periodically in patients with cutaneous lesions suggestive of this condition.

Brain Diseases↗
PubMed2006

Melanosis intestini: case report.

The term melanosis in the gastrointestinal tract refers to the accumulation of pigment deposits in the mucosa. Melanosis of the colon is not uncommon and has been associated with certain conditions, however melanosis of the small intestine is extremely rare. Herein, we describe a case in which we observed melanosis not only in the colon, but in the terminal ileum as well, associated with the use of anthraceneline laxatives. The clinical significance of this condition is not clear, however Gastroenterologists and Pathologists should be aware of its existence.

Journal Article↗
PubMedDate not supplied

[Melanosis oculi and malignant choroid melanoma].

The patient aged 75 years presents since her youth, in the left eye, ocular melanosis with abnormal pigmentation of the sclerotic, hyperpigmentation of the iris and abnormal pigmentation of the fundus oculi. Six months ago, she noticed that she is not able to see with this eye, and the fundus oculi examination emphasizes a malignant choroidal melanoma, with a fixed detachment of the retina. The authors show that the denomination Bourquin's benign ocular melanosis, under which the affection is known, is improper, as 10% of the cases of ocular melanosis degenerate into melanosarcomas. The term melanosis oculi is the most adequate one.

Aged↗
PubMed1996

[Melanoma developped on nevus of Ota without ocular melanosis. Apropos of an anatomo-clinical case].

The naevus of Ota is a congenital pigmentary disorder usually involving the skin of the face in areas supplied by the first and second branches of the trigeminal nerve. Ipsilateral ocular melanosis is associated in 2/3 of the cases. The naevus occurrs most often in Asians. There have been 66 reported cases of malignant transformation of the naevus of Ota, generally affecting caucasians: 23 were melanomas of the eyeball (mostly of the choroid), and 13 were orbital melanomas. Only 4 cases of melanomas associated with a naevus of Ota without ocular melanosis have been previously described. We report a new case of orbital melanoma affecting a 30-year-old man. This melanoma complicated a right type III of Tanino naevus of Ota without ocular melanosis. The location of the tumor to the orbital apex and its extension to the spheno-cavernous area was responsible for an ipsilateral loss of vision without proptosis, which has not yet been described in any case of naevus of Ota without ocular melanosis.

Adult↗
PubMed1989

Prostatic carcinoma with melanosis.

Melanosis in which melanin deposition is found in the epithelia and stroma or blue nevus of the prostate gland is an uncommon lesion, and the histogenesis is still unclear. To our knowledge, there have been only two case reports in which prostatic melanosis and prostatic adenocarcinoma were both present. This article reports a third case having this combination and discusses the existence of melanin pigment in the carcinoma cell with melanosis.

Adenocarcinoma↗
PubMed1995

MR of leptomeningeal melanosis in children.

PURPOSE: To delineate the magnetic resonance (MR) appearance of leptomeningeal melanosis in children. METHOD: Retrospective review of the medical, surgical, pathologic and MR findings in four children with a confirmed histologic diagnosis of leptomeningeal melanosis. The brain MR was performed with T1- and T2-weighted images in all four children and three had T1-weighted post-gadolinium images. Two of the children also had T1-weighted post gadolinium spine images. RESULTS: The MR brain findings consisted of cortical plaque and nodular hyperintense lesions on the noncontrast T1-weighted images in one child, marked, diffuse leptomeningeal enhancement in two children, and an enlarged, hypointense left temporal lobe with adjacent mild leptomeningeal enhancement in one child. The MR spine findings consisted of diffuse leptomeningeal enhancement in one child and hyperintensity of the cerebrospinal fluid in the other. CONCLUSION: The T1-weighted pre- and post-contrast images were the best to demonstrate the MR findings in leptomeningeal melanosis which consisted of either diffuse or localized enhancement of the leptomeninges; or cortical plaque and nodular hyperintense lesions pre-contrast.

Adolescent↗
PubMed2004

Vulvar melanoma: diffuse melanosis and metastasis to the placenta.

Mucocutaneous melanoma, including vulvar melanoma, is rare and has a worse prognosis and higher recurrence rate than traditional cutaneous melanoma. Diffuse cutaneous melanosis is another rare clinical presentation of metastatic melanoma. It is essential for dermatologists to be alerted to rare presentations of melanoma, to facilitate early detection. We present the first case to our knowledge of metastatic vulvar melanoma with diffuse cutaneous melanosis in a pregnant young woman. Despite the occurrence of placental metastasis, a healthy, unaffected baby was born. This case exemplifies the aggressiveness of vulvar melanoma. The genitalia should be included in routine total body skin examinations. Pregnant women with generalized melanosis may be at increased risk for placental metastasis of melanoma. Pregnancy does not alter the incidence or prognosis of melanoma; however, patients with a poor prognosis or high recurrence risk should be informed of potential pregnancy complications associated with melanoma recurrence or metastasis.

Adult↗