High density of M2-macrophages in acral lentiginous melanoma compared to superficial spreading melanoma

Abstract Purpose Acral lentiginous melanoma (ALM), a relatively rare subtype of cutaneous melanoma, has been reported to have a worse prognosis than other melanomas. We aimed to assess clinical findings in Caucasian ALM patients and compare the data with a matched cohort of superficial spreading melanoma (SSM) patients. Methods We studied 63 patients with ALM and 63 randomly stage- and limb-matched patients with SSM (non-ALM). In both cohorts, guideline-adjusted diagnosis, treatment and follow-up were performed. Results We did not observe differences in prognostic factors (e.g., tumor thickness, ulceration) between the two cohorts. Both in ALM and non-ALM patients positive sentinel lymph node was a significant independent predictor for disease relapse and melanoma-specific death. However, disease relapse and melanoma-specific death rates did not significantly differ between ALM and non-ALM patients. An overall 5-year melanoma-specific survival of 82.5% and 81% was observed in ALM and non-ALM patients, respectively. Conclusions Our data confirm that patients with ALM have no worse outcome than non-ALM patients when correcting for significant prognostic factors. Hence, the reportedly high rates of fatal ALM cases should not be ascribed to pathobiological differences between ALM and non-ALM but are most likely are a consequence of a delay in diagnosis and thus advanced stage of ALM.

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Clinico-pathological Study of Malignant Melanoma in A Tertiary Care Centre

Journal of Nepal Medical Association ◽

10.31729/jnma.2888 ◽

2017 ◽

Vol 56 (205) ◽

pp. 132-136 ◽

Cited By ~ 1

Author(s):

Sushma Thapa ◽

Arnab Ghosh ◽

Dilasma Ghartimagar ◽

Tillotama Prasad ◽

Raghavan Narasimhan ◽

...

Keyword(s):

Malignant Melanoma ◽

Tertiary Care ◽

Lower Extremities ◽

Breslow Thickness ◽

Superficial Spreading ◽

Tertiary Care Centre ◽

Acral Lentiginous Melanoma ◽

Histologic Subtype ◽

Superficial Spreading Melanoma ◽

Nodular Melanoma

Introduction: Malignant melanoma, which causes three fourth of all deaths related to skin cancer, is more common in Caucasian population compared to Asian population. There is no reliable information about malignant melanoma in Nepal hence an effort has been made to assess the clinical and pathological features of melanoma patients. Methods: This was a retrospective hospital based study done in the department of Pathology. All cases of malignant melanoma diagnosed on biopsy during a period of 13 years were retrieved, reviewed and collated. Results: We had 35 cases with age range from 15 to 84 years with the mean of 51.4 years and M: F of 1.3:1. The predominant site was lower extremities. Most cases were less than 3 cm. Majority of histologic subtypes were nodular melanoma 29 (82.8%) followed by mucosal lentiginous melanoma 3 (8.6%), superficial spreading melanoma 2 (5.7%) and acral lentiginous melanoma 1 (2.9%). Half (50%) of the excisional biopsies were at Clark’s level IV and 75% were at high Breslow thickness. Conclusions: The most frequent site in males and females were lower extremities and trunk respectively in contrast to Western studies where it is opposite. Nodular melanoma was the commonest histologic subtype while in other Asian studies and in Western studies majority were acral lentiginous melanoma and superficial spreading melanoma respectively. Keywords: Breslow thickness; Clark’s level; malignant melanoma; nodular melanoma.

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Evolution of superficial spreading melanoma to resemble desmoplastic melanoma: case report

Virchows Archiv ◽

10.1007/s00428-021-03127-0 ◽

2021 ◽

Author(s):

Martin G. Cook ◽

Barry W. E. M. Powell ◽

Megan E. Grant ◽

Adele C. Green

Keyword(s):

Case Report ◽

Clinical Management ◽

Unusual Case ◽

Primary Site ◽

Mixed Tumor ◽

Superficial Spreading ◽

Superficial Spreading Melanoma ◽

Desmoplastic Melanoma ◽

Mixed Features ◽

Melanoma Case

AbstractDesmoplastic melanoma commonly occurs on the head and neck in a pure form, but occasionally, it occurs in a mixed tumor with another type, usually superficial spreading melanoma (SSM), and rarely as a metastasis from a primary SSM. We report here a primary SSM on the leg of a 32-year-old male which metastasised to lymph nodes, and 10 years later recurred at the primary site initially with mixed features but evolving to resemble a uniformly desmoplastic, deeply invasive melanoma. This unusual case has implications for clinical management and is additionally notable for its reversal in behavior, from metastatic to local infiltrative type, correlating with the change in morphology.

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Cutaneous Melanomas Arising during Childhood: An Overview of the Main Entities

Dermatopathology ◽

10.3390/dermatopathology8030036 ◽

2021 ◽

Vol 8 (3) ◽

pp. 301-314

Author(s):

Arnaud de la Fouchardière ◽

Felix Boivin ◽

Heather C. Etchevers ◽

Nicolas Macagno

Keyword(s):

Lymph Node ◽

Regional Lymph Node ◽

Germline Mutations ◽

Epithelioid Cells ◽

Superficial Spreading ◽

Superficial Spreading Melanoma ◽

Cancer Predisposition Syndrome ◽

Specific Morphology ◽

Genetic Features ◽

Molecular Assessment

Cutaneous melanomas are exceptional in children and represent a variety of clinical situations, each with a different prognosis. In congenital nevi, the risk of transformation is correlated with the size of the nevus. The most frequent type is lateral transformation, extremely rare before puberty, reminiscent of a superficial spreading melanoma (SSM) ex-nevus. Deep nodular transformation is much rarer, can occur before puberty, and must be distinguished from benign proliferative nodules. Superficial spreading melanoma can also arise within small nevi, which were not visible at birth, usually after puberty, and can reveal a cancer predisposition syndrome (CDKN2A or CDK4 germline mutations). Prognosis is correlated with classical histoprognostic features (mainly Breslow thickness). Spitz tumors are frequent in adolescents and encompass benign (Spitz nevus), intermediate (atypical Spitz tumor), and malignant forms (malignant Spitz tumor). The whole spectrum is characterized by specific morphology with spindled and epithelioid cells, genetic features, and an overall favorable outcome even if a regional lymph node is involved. Nevoid melanomas are rare and difficult to diagnose clinically and histologically. They can arise in late adolescence. Their prognosis is currently not very well ascertained. A small group of melanomas remains unclassified after histological and molecular assessment.

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