Acral Lentiginous Melanoma, Indolent Subtype Diagnosed by <i>En Bloc</i> Excision: A Case Report

Ohn, Jungyoon; Bae, Jeong Mo; Lim, Ji Soo; Park, Jong Seo; Yoon, Hyun Sun; Cho, Soyun; Park, Hyun Sun

doi:10.5021/ad.2017.29.3.327

Cited by 7 publications

(8 citation statements)

References 14 publications

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“…34,35 Moreover, indolent acral melanoma with long radial growth phase has been reported in Asian populations, and we found many similar cases of acral melanoma presenting longer horizontal diameter than tumor thickness in our cohort. 18,19 These observations may contribute to explaining the lack of significant difference in Breslow thickness between acral and nonacral melanoma in this study.…”

Section: Discussionmentioning

confidence: 62%

“…18 Huge acral melanoma with a clinical diameter measuring 4-6 cm without dermal invasion has been described. 18,19 A peculiar spreading pattern has been observed in acral melanoma which may be associated with predisposing factors, anatomical structures and genetic predisposition that differ from non-acral melanoma. 20,21 We performed this study to elucidate whether there is any difference in progression pattern between acral and nonacral melanoma.…”

Section: Introductionmentioning

confidence: 99%

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Different progression pattern between acral and nonacral melanoma: A retrospective, comparative, clinicoprognostic study of 492 cases of primary cutaneous melanoma according to tumor site

Jung

Won

et al. 2021

IJDVL

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Background: There are limited data regarding the difference in progression pattern between acral melanoma and nonacral melanoma. Aims: The objectives of this study were to compare the progression pattern between acral and nonacral melanoma and evaluate its impact on clinical outcomes. Methods: Clinical and histopathological features, survival outcomes and prognostic factors of 492 patients with acral melanoma or nonacral melanoma were retrospectively evaluated using the Asan Medical Center database. Results: The male-to-female ratio and the mean age was 1:0.92 and 60.2 years for acral melanoma (n = 249), and 1:0.85 and 58.4 years for nonacral melanoma (n = 243), respectively. The demographic difference was not significant. Although prediagnosis duration was longer and the advanced stage was more common in acral melanoma than that in nonacral melanoma, the vertical growth phase was more common in nonacral melanoma than that in acral melanoma, whereas, the horizontal diameter is longer in acral melanoma than that in nonacral melanoma. Dissemination to lymph node was more common in acral melanoma than that in nonacral melanoma. Lymph node involvement was associated with deeper Breslow thickness in nonacral melanoma but not in acral melanoma. The degree of correlation of prediagnosis duration with horizontal diameter was remarkable in acral melanoma, but with Breslow thickness in nonacral melanoma. Overall survival was worse in acral melanoma than that in nonacral melanoma. The prognostic value of Breslow thickness was more remarkable in nonacral melanoma than that in acral melanoma. Limitations: This study is a retrospective, single-center design. Conclusion: Acral melanoma has a longer radial growth phase compared with nonacral melanoma. However, acral melanoma is commonly associated with lymph node dissemination which contributed to worse survival in acral melanoma than nonacral melanoma.

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Section: Discussionmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Different progression pattern between acral and nonacral melanoma: A retrospective, comparative, clinicoprognostic study of 492 cases of primary cutaneous melanoma according to tumor site

Jung

Won

et al. 2021

IJDVL

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“…Aggressive tumor behavior, 7,19,20 poor biopsy technique or failure to biopsy in the earliest disease stages, 7,11,[21][22][23][24][25][26][27][28][29] Because risks factors for SUM are unknown, early detection is the currently only way to potentially improve survival and functionality in these patients. 24,35,36 The incidence of SUM increased 2.04% annually 2012 to 2016, with the nail biopsy rate increasing at a faster rate, except for those performed by dermatologists (8.62% decrease).…”

Section: Discussionmentioning

confidence: 99%

Retrospective analysis of nail biopsies performed using the Medicare Provider Utilization and Payment Database 2012 to 2017

Wang

Lipner

2021

Dermatologic Therapy

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Subungual melanoma (SUM) is subset of acral melanoma that develops within the nail unit and is associated with a poor prognosis. Nail biopsy is the only way to definitively diagnosis SUM. Our objectives were to analyze the Medicare database for nail biopsy utilization and to compare the annual nail biopsy rate with the estimated incidence of SUM in the United States. A retrospective study on nail biopsy data was performed using the Medicare Provider Utilization and Payment Database 2012 to 2017. The number of nail biopsies performed per 100 000 people was compared to SUM incidence per 100 000 people. Podiatrists, dermatologists, other physicians, and NP/PAs respectively performed 12.12, 0.42, 0.08, 0.07 nail biopsies per 100 000 people annually. Dermatologists performed adequate nail biopsies to cover the minimum (0.7%), but not the maximum (3.5%) estimated incidence of SUM. Only 0.28% and 1.01% of general dermatologists and Mohs surgeons, respectively, performed nail biopsies in 19/50 (38.00%) states and 69/929 (7.42%) zip codes. Limitations of our study were that nail biopsies on patients less than 65 years, and those with no or commercial health insurance were not analyzed. In sum, very few dermatologists performed nail biopsies in the Medicare database. Increased efforts are needed to educate dermatologists on nail surgery.

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“…2). 20,24 In ambiguous cases, fluorescence in situ hybridization (FISH) can provide additional information. A study analyzing seven cases of NM by FISH showed that NM commonly presented 6p25 (RREB1) gain (100%), 11q13 (CCND1) gain (86%), and both 6q23 (MYB) loss and 8q24.1 (MYC) gain (71%).…”

Section: Histopathology Findingsmentioning

confidence: 99%

Diagnosis and treatment of nail melanoma: a review of the clinicopathologic, dermoscopic, and genetic characteristics

Darmawan

Ohn

Mun

et al. 2022

Acad Dermatol Venereol

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Nail melanoma (NM) is an important differential diagnosis in patients with longitudinal melanonychia. However, diagnosis is often challenging as it is difficult to differentiate from other pigmented nail disorders. The main challenge for diagnosis is obtaining adequate nail matrix biopsy specimens for histopathological assessment. Furthermore, the histopathological changes in the early stages of NM are subtle and contribute to a delay in diagnosis and care. Therefore, the integration of clinical and histopathological analyses is essential. Clinical and dermoscopic features, such as a broadened width of asymmetric bands in an irregular pattern, with multicolour pigmentation, periungual pigmentation, and continuous growth, are features that support the diagnosis of NM. The essential histological features that must be assessed are cellular morphology, architectural features, melanocyte density, and inflammatory changes. The reported mutations in NMs were BRAF (0–43%), NRAS (0–31%), KIT (0–50%), NF1 (0–50%), and GNAQ (0–25%). Surgery is the primary treatment for NM. The recommended treatment for in situ or minimally invasive NM is functional surgery, but cases with suspected bone invasion should be treated with amputation. Targeted therapy and immunotherapy are indicated for advanced stages of NM. This review summarizes the updated guidelines for the diagnosis and treatment of NM.

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Acral Lentiginous Melanoma, Indolent Subtype Diagnosed by En Bloc Excision: A Case Report

Cited by 7 publications

References 14 publications

Different progression pattern between acral and nonacral melanoma: A retrospective, comparative, clinicoprognostic study of 492 cases of primary cutaneous melanoma according to tumor site

Different progression pattern between acral and nonacral melanoma: A retrospective, comparative, clinicoprognostic study of 492 cases of primary cutaneous melanoma according to tumor site

Retrospective analysis of nail biopsies performed using the Medicare Provider Utilization and Payment Database 2012 to 2017

Diagnosis and treatment of nail melanoma: a review of the clinicopathologic, dermoscopic, and genetic characteristics

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