Melanoma clinical presentation

Cytokines have been under clinical investigation as adjuvants to vaccines, and IFNs and IL-2 have shown some positive effects in the response of human subjects to hepatitis vaccine. IL-12 and GM-CSF have also shown adjuvant effects with vaccines. GM-CSF is of particular interest because it promotes recruitment of professional antigen-presenting cells such as the dendritic cells required for priming naive antigen-specific T-lymphocyte responses. There are some claims that GM-CSF can itself stimulate an antitumor immune response, resulting in tumor regression in melanoma and prostate cancer. 

David W. Roadcap, Christoph S. Clemen and James E. Bear present the involvement of coronins in multiple diseases. They highlight possible functions of coronins-lB and -1C in clinically relevant processes such as brain development and neural regeneration. Moreover, coronin-1C is up-regulated in multiple types of cUnically aggressive cancer, particularly in the progression of melanoma and glioma (Chapter 11). 

At present, non-morphologic techniques to evaluate the prognosis of MMs must be regarded as investigational and cannot yet be recommended for routine clinical application. All necessary pathologic data such as tumor location, size, depth, ulceration, mitotic activity, and growth phase can still be obtained by examination of standard microscopic preparations of melanoma as stained with hematoxylin and eosin. 

A notable exception to that statement is represented by clear cell sarcoma of soft tissue ( melanoma of soft parts ), which clearly does exhibit true melanocytic dif-ferentiation.2° 2° Because the immunohistologic profiles of that tumor and MM are superimposable, other specialized studies are usually necessary to separate them in cases where clinical findings make the diagnosis uncertain. In particular, clear cell sarcoma regularly shows the presence of a t(12 22) chromosomal translocation, apposing the EWS and ATFl genes, which is not present in melanomas. 

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