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Gerami melanoma

Laura K Ferris, Aaron S Farberg, Brooke Middlebrook, Clare E Johnson, Natalie Lassen, Kristen M Oelschlager, Derek J Maetzold, Robert W Cook, Darrell S Rigel, Pedram Gerami
BACKGROUND: A significant proportion of patients with American Joint Committee on Cancer (AJCC)-defined early-stage cutaneous melanoma have disease recurrence and die. A 31-gene expression profile (GEP) that accurately assesses metastatic risk associated with primary cutaneous melanomas has been described. OBJECTIVE: We sought to compare accuracy of the GEP in combination with risk determined using the web-based AJCC Individualized Melanoma Patient Outcome Prediction Tool...
May 2017: Journal of the American Academy of Dermatology
Emily A Merkel, Pedram Gerami
In most cases of cutaneous melanoma, ultraviolet (UV) radiation is recognized as a prominent risk factor. Less is known regarding the mechanisms of mutagenesis for melanoma arising in sun-protected sites, such as acral and mucosal melanoma. Acral and mucosal melanoma share many common features, including a late age of onset, a broad radial growth phase with prominent lentiginous growth, the presence of field cancerization cells, and, in most cases, lack of a precursor nevus. In addition to early chromosomal instability, many of the same genes are also involved in these two distinct melanoma subtypes...
January 16, 2017: Laboratory Investigation; a Journal of Technical Methods and Pathology
Alexandra M Haugh, Emily A Merkel, Bin Zhang, Jeffrey A Bubley, Anna Elisa Verzì, Christina Y Lee, Pedram Gerami
BACKGROUND: Genital melanosis may clinically mimic melanoma. Little is known about the potential risk for genital and nongenital melanoma in these patients. OBJECTIVE: In this retrospective cohort study, we analyzed clinical and histologic data from patients with genital melanosis to better characterize these lesions and the risk they confer for genital and nongenital melanoma. METHODS: In all, 41 patients were identified for a retrospective chart review and histologic analysis...
May 2017: Journal of the American Academy of Dermatology
Klaus J Busam, Kara N Shah, Pedram Gerami, Thomas Sitzman, Achim A Jungbluth, Veronica Kinsler
The formation of a nodule within a congenital melanocytic nevus (CMN) raises concerns about possible melanoma. Most new nodular growths that develop during childhood, however, are benign proliferative nodules (PN); melanoma is very rare. The distinction of melanoma from PN can at times be difficult clinically and histopathologically, requiring ancillary molecular tests for diagnosis. Although the application of molecular methods has revealed new insights into the mutational and genomic landscape of childhood melanomas, little is known about epigenetic events that may drive the growth of a melanoma or PN in a CMN...
March 2017: American Journal of Surgical Pathology
Sapna M Amin, Alexandra M Haugh, Christina Y Lee, Bin Zhang, Jeffrey A Bubley, Emily A Merkel, Anna Elisa Verzì, Pedram Gerami
Recent studies have identified translocations involving the kinase domains of ALK, NTRK1, BRAF, RET, and ROS in spitzoid neoplasms. Subsequent studies have also characterized morphologic features corresponding to ALK and NTRK1 translocations. In this study, we sought to further compare morphologic features across a range of 49 genetically defined spitzoid neoplasms with ALK, NTRK1, BRAF, or RET fusions to determine discriminating features. We also compared them with a group of 22 spitzoid neoplasms, which were confirmed to be negative for fusions in ALK, NTRK1, BRAF, and RET...
April 2017: American Journal of Surgical Pathology
Pedram Gerami, Zuxu Yao, David Polsky, Burkhard Jansen, Klaus Busam, Jonhan Ho, Mary Martini, Laura K Ferris
BACKGROUND: Clinical and histopathologic assessment of pigmented skin lesions remains challenging even for experts. Differentiated and accurate noninvasive diagnostic modalities are highly desirable. OBJECTIVE: We sought to provide clinicians with such a tool. METHODS: A 2-gene classification method based on LINC00518 and preferentially expressed antigen in melanoma (PRAME) gene expression was evaluated and validated in 555 pigmented lesions (157 training and 398 validation samples) obtained noninvasively via adhesive patch biopsy...
January 2017: Journal of the American Academy of Dermatology
Luigi Strizzi, Naira V Margaryan, Pedram Gerami, Zahra Haghighat, Paul W Harms, Gabriele Madonna, Gerardo Botti, Paolo A Ascierto, Mary J C Hendrix
The TGF-β associated growth factor Nodal is highly expressed in aggressive metastatic melanoma. Determining the risk for melanomagenesis from Nodal expression in nevi prior to the development of melanoma may be useful for both the screening and prevention of melanoma. Tissue sections of human adult nevi with or without a history of melanoma were stained by immunohistochemistry (IHC) for Nodal, the Nodal co-receptor Cripto-1, and Notch4, which have previously been shown to be associated with Nodal expression in melanoma...
August 2016: Oncology Letters
Christina Y Lee, Lauren M Sholl, Bin Zhang, Emily A Merkel, Sapna M Amin, Joan Guitart, Pedram Gerami
The natural history of atypical Spitz neoplasms remains poorly understood, resulting in significant patient and clinician anxiety. We sought to better characterize outcomes that correlated with molecular features by performing a prospective cohort study of pediatric atypical spitzoid neoplasms in which fluorescence in situ hybridization studies were obtained for diagnosis. Cases with sufficient tissue underwent additional retrospective assessment for translocations in ALK, NTRK1, BRAF, RET, and ROS1. Among 246 total patients assessed, 13% had a positive fluorescence in situ hybridization result...
March 2017: American Journal of Dermatopathology
Emily A Merkel, Mary C Martini, Sapna M Amin, Christina Y Lee, Pedram Gerami
BACKGROUND: Nevi of special sites display aberrant clinical and histologic features that can be difficult to distinguish from melanoma, leading to unnecessarily high rates of excision with poor cosmetic or functional results. Dermoscopy can improve clinical assessment of melanocytic lesions by visualizing morphologic structures beyond the epidermis. OBJECTIVE: We sought to assess the value of specific dermoscopic features for diagnosing melanocytic neoplasms arising on the breast area in females...
August 2016: Journal of the American Academy of Dermatology
Christina A Minami, Jeffrey D Wayne, Anthony D Yang, Mary C Martini, Pedram Gerami, Sunandana Chandra, Timothy M Kuzel, David P Winchester, Bryan E Palis, Karl Y Bilimoria
INTRODUCTION: To increase adherence to cancer management guidelines, the Commission on Cancer (CoC) developed and approved five melanoma quality measures in 2015. Our objectives were to evaluate formally the national performance of these melanoma measures and to examine patient, tumor, and hospital characteristics associated with adherence. METHODS: From the National Cancer Data Base (2012), patients with invasive, nonmetastatic melanoma were identified. Inclusion and exclusion criteria were based on the CoC definition for each measure...
October 2016: Annals of Surgical Oncology
Oriol Yélamos, Emily A Merkel, Lauren Meldi Sholl, Bin Zhang, Sapna M Amin, Christina Y Lee, Gerta E Guitart, Jingyi Yang, Alexander T Wenzel, Christopher G Bunick, Pedram Yazdan, Jaehyuk Choi, Pedram Gerami
Genital melanomas (GM) are the second most common cancer of the female external genitalia and may be confused with atypical genital nevi (AGN), which exhibit atypical histological features but have benign behavior. In this study, we compared the clinical, histological, and molecular features of 19 GM and 25 AGN. We described chromosomal copy number aberrations and the mutational status of 50 oncogenes and tumor suppressor genes in both groups. Our study showed that a pigmented lesion occurring in mucosal tissue, particularly in postmenopausal women, was more likely to be a melanoma than a nevus...
September 2016: Journal of Investigative Dermatology
Jason P Lott, Joann G Elmore, Ge A Zhao, Stevan R Knezevich, Paul D Frederick, Lisa M Reisch, Emily Y Chu, Martin G Cook, Lyn M Duncan, Rosalie Elenitsas, Pedram Gerami, Gilles Landman, Lori Lowe, Jane L Messina, Martin C Mihm, Joost J van den Oord, Michael S Rabkin, Birgitta Schmidt, Christopher R Shea, Sook Jung Yun, George X Xu, Michael W Piepkorn, David E Elder, Raymond L Barnhill
BACKGROUND: Pathologists use diverse terminology when interpreting melanocytic neoplasms, potentially compromising quality of care. OBJECTIVE: We sought to evaluate the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx) scheme, a 5-category classification system for melanocytic lesions. METHODS: Participants (n = 16) of the 2013 International Melanoma Pathology Study Group Workshop provided independent case-level diagnoses and treatment suggestions for 48 melanocytic lesions...
August 2016: Journal of the American Academy of Dermatology
Christina Y Lee, Pedram Gerami
Molecular tools are rapidly emerging as novel tools for clinicians caring for cancer patients. Roles for these assays in melanocytic neoplasms include diagnosis for histologically ambiguous tumors, prognosis for conventional melanoma, and theragnosis for advanced disease. The introduction of these molecular strategies is timely, as different therapeutic options are rapidly developing to treat melanoma. With the development of new and effective therapeutic options, it is more critical than ever to improve the discrimination between patients with aggressive disease and those with more indolent tumours...
February 2016: Pathology
Emily A Merkel, Sapna M Amin, Christina Y Lee, Alfred W Rademaker, Pedram Yazdan, Mary C Martini, Joan Guitart, Pedram Gerami
BACKGROUND: Dermoscopy allows for visualization of morphologic structures beyond the epidermis, including features that may indicate early malignant transformation. However, dermoscopic features are rarely considered during routine histologic sectioning, and areas of clinical concern may be missed during microscopic evaluation. OBJECTIVE: We assessed the diagnostic impact of a dermoscopy-guided micropunch score for the evaluation of melanocytic lesions. METHODS: In this case-control study, we evaluated 150 scored melanocytic lesions...
June 2016: Journal of the American Academy of Dermatology
Emily A Merkel, Mary C Martini, Sapna M Amin, Oriol Yélamos, Christina Y Lee, Lauren M Sholl, Alfred W Rademaker, Joan Guitart, Pedram Gerami
BACKGROUND: The influence of pregnancy on the development, progression, and prognosis of melanoma is controversial. OBJECTIVE: We sought to compare clinical characteristics, histologic features, and proliferative activity in pregnancy-associated melanoma (PAM) and melanoma in nonpregnant women of reproductive age (non-PAM). METHODS: In this retrospective cohort study, we reviewed medical records and pathology reports from women given a diagnosis of melanoma between 2006 and 2015...
January 2016: Journal of the American Academy of Dermatology
Oriol Yélamos, Klaus J Busam, Christina Lee, Lauren Meldi Sholl, Sapna M Amin, Emily A Merkel, Roxana Obregon, Joan Guitart, Pedram Gerami
BACKGROUND: Nevoid melanomas include melanomas with a low power silhouette similar to melanocytic nevi. However, at higher power magnification, nevoid melanoma may have severe nuclear atypia and dermal mitoses. METHODS: We performed a clinical, pathological and molecular study on a series of 58 examples of nevoid melanoma, excluding cases with spitzoid morphology. RESULTS: We identified distinct morphologic patterns: 'classic' nevoid melanoma, superficial spreading melanomas with nevoid invasive melanoma, lentigo maligna with nevoid invasive melanoma and deep penetrating nevus-like nevoid melanoma...
November 2015: Journal of Cutaneous Pathology
Tracy Donahue, Christina Y Lee, Asmi Sanghvi, Roxana Obregon, Michael Sidiropoulos, Chelsea Cooper, Emily A Merkel, Oriol Yélamos, Laura Ferris, Pedram Gerami
BACKGROUND: A number of factors other than those identified by the American Joint Committee on Cancer (AJCC) may have prognostic significance in the evaluation of melanoma. OBJECTIVE: We sought to evaluate commonly recorded clinical features potentially associated with aggressive melanoma. METHODS: We conducted a retrospective case-control study. We included patients given a diagnosis of cutaneous melanoma with at least 5 years of follow-up or documented metastases...
September 2015: Journal of the American Academy of Dermatology
Sapna M Amin, Chelsea Cooper, Oriol Yélamos, Christina Y Lee, Lauren M Sholl, Arnaud de la Fouchardiere, Joan Guitart, Pedram Gerami
BACKGROUND: The histogenesis and clinical behavior of combined cutaneous tumors (CCTs) in which the mesenchymal component consists of melanoma remain unclear. OBJECTIVE: We sought to characterize the clinical, histologic, and molecular findings in CCTs with an epithelial and a melanoma component. METHODS: We retrospectively reviewed the records from 2 institutions for CCTs. Fluorescence in situ hybridization was performed to assess chromosomal copy number alterations in both components...
September 2015: Journal of the American Academy of Dermatology
Pedram Gerami, Oriol Yélamos, Christina Y Lee, Roxana Obregon, Pedram Yazdan, Lauren M Sholl, Gerta E Guitart, Ching-Ni Njauw, Hensin Tsao
IMPORTANCE: Several kindreds having germline BAP1 mutations with a propensity for uveal and cutaneous melanomas and other internal malignancies have been described in an autosomal dominant tumor predisposition syndrome. However, clinically atypical moles have not been previously recognized as a component of this syndrome, to our knowledge. We describe the first kindred to date with a germline mutation in BAP1 associated with multiple cutaneous melanomas and classic dysplastic nevus syndrome...
November 2015: JAMA Dermatology
Chelsea Cooper, Nicoleta C Arva, Christina Lee, Oriol Yélamos, Roxana Obregon, Lauren M Sholl, Annette Wagner, Lisa Shen, Joan Guitart, Pedram Gerami
BACKGROUND: The current literature suggests that approximately 5% to 10% of melanonychia striata cases in adults are the result of subungual melanoma. OBJECTIVE: We sought to evaluate the clinical and histopathologic features and to determine the outcomes and causes of melanonychia striata in a cohort of children. METHODS: We assessed 30 childhood cases of melanonychia striata for features typically associated with melanoma such as Hutchinson sign, width of the pigmented band, evolution, color, and nail dystrophy...
May 2015: Journal of the American Academy of Dermatology
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