Cutaneous Melanomas Associated With Nevi

Bevona, Caroline; Goggins, William C.; Quinn, Timothy R.; Fullerton, Julie; Tsao, Hensin

doi:10.1001/archderm.139.12.1620

Cited by 230 publications

(198 citation statements)

References 28 publications

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“…Our observed prevalence of contiguous neval remnants in approximately half of all SSM but only 11% of LM/LMM is similar in magnitude to previously reported estimates. [10][11][12][13][14][15] Because of these marked differences by histologic type, we restricted further analyses to melanomas of the superficial spreading type. We found that SSM of the H & N was significantly less likely than SSM of the back to be associated with a contiguous nevus in accord with earlier descriptive studies of the anatomical distribution of nevusassociated melanoma.…”

Section: Discussionmentioning

confidence: 99%

Sun exposure and host phenotype as predictors of cutaneous melanoma associated with neval remnants or dermal elastosis

Lee

Williamson

Watt

et al. 2006

Intl Journal of Cancer

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Recent research suggests that cutaneous melanomas may arise through 2 distinct pathways, characterized by chronic sun exposure on one hand and nevus-prone phenotype of the host on the other. Two histological characteristics of melanoma consistent with these divergent origins are dermal elastosis in adjacent skin and neval remnants contiguous with the tumor, respectively. To further explore causal heterogeneity in melanoma, we compared sun exposure histories and phenotypic characteristics among a population-based sample of patients newly diagnosed with cutaneous melanoma with and without contiguous neval remnants or dermal elastosis. Tissue blocks were obtained for 141 patients: 53 with superficial spreading melanoma (SSM) of the back, 42 with SSM of head and neck (H & N), and 39 and 7 with lentigo maligna/lentigo maligna melanoma (LM/LMM) of the H & N and back, respectively. Melanomas of the H & N were less likely than those on back to have neval remnants (adjusted OR 0.6, 95% CI 0.3-1.4), but were significantly more likely to have dermal elastosis (adjusted OR 9.3, 95% CI 3.5-25). In site-specific analyses, we found that H & N melanomas with neval remnants were more likely than those without neval remnants to arise in people with more than 60 nevi (adjusted OR 2.1, 95% CI 0.3-14.3), but were less likely to arise in those with more than 20 actinic keratoses. Less marked associations were observed for melanomas of the back. High levels of sun exposure strongly predicted dermal elastosis for H & N melanomas (OR 22.5, 95% CI 2.1-245), but not for melanomas of the back (OR 2.1, 95% CI 0.4-11). We conclude that melanomas with different histologic characteristics have different risk factor profiles, particularly on the head and neck. These data accord with the hypothesis that melanomas arise through different causal pathways. ' 2006 Wiley-Liss, Inc.

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Section: Discussionmentioning

confidence: 99%

Sun exposure and host phenotype as predictors of cutaneous melanoma associated with neval remnants or dermal elastosis

Lee

Williamson

Watt

et al. 2006

Intl Journal of Cancer

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“…The concordant findings from descriptive and analytical studies are consistent with melanomas at different body sites arising through different pathways, but do not shed light on the mechanisms of pathogenesis. To address this issue, investigators have systematically appraised histological features and noted that melanomas arising from a benign melanocytic nevus differ from those arising de novo, being more frequent on the trunk than the head and neck, and being associated with young age and high nevus counts [20][21][22][23]. These congruent findings point to one group of melanomas arising through a high-nevus/low-sunlight pathway (predominantly on the trunk) and another group of mainly head and neck melanomas arising through a low-nevus/high-sunlight pathway.…”

Section: David C Whitemanmentioning

confidence: 99%

Testing the divergent pathway hypothesis for melanoma: recent findings and future challenges

Whiteman¹

2010

Expert Review of Anticancer Therapy

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“…8 However, the best evidence for this association is the histological recognition of dysplastic nevi in contiguity with a melanoma, which is observed in about 20-40% of cases in most studies. [12][13][14][15][16][17] Thus, the majority of melanomas do not arise in association with a demonstrable nevus. The prevalence of dysplastic nevi is vastly greater in populations than that of melanoma, indicating, consistent with clinical observations, 18 that most dysplastic nevi are stable and do not progress to melanoma.…”

Section: Dysplastic Nevimentioning

confidence: 99%

Precursors to melanoma and their mimics: nevi of special sites

2006

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Melanocytic nevi, which are benign tumors of melanocytes, may have occasional cosmetic significance but, for the most part, they are important only in relation to melanoma. Nevi are the most important simulants of melanoma, both clinically and histologically, and can usually be reliably distinguished from melanomas using published criteria. Some lesions are characterized by greater degrees of atypia and may be more difficult to diagnose. Dysplastic nevi are among the most important simulants of melanoma. Nevi may also be important as potential precursors of melanoma; however, most nevi are stable and will not progress to malignancy. Nevi are vastly more common than melanomas and the rate of progression of individual lesions is very low. Therefore, nevi are not as a rule managed by wholesale excision to prevent melanoma. Nevi are also important as risk markers, identifying individuals at greater risk of developing melanoma in the future. Dysplastic nevi and, to a lesser extent, common acquired and congenital nevi are among the most important melanoma risk markers. Nevi of special sites have been identified as nevi that may show atypical features suggestive of a dysplastic nevus or of a melanoma. However, they are not risk markers and they are not malignancies. Nevi of genital skin, acral skin, and flexural skin are among the most important 'nevi of special sites'. It is important, in considering the differential diagnosis of a lesion in a special site, to avoid overcalling such a lesion as a melanoma or a dysplastic nevus because this could lead to excessive treatment. Conversely, it is important to avoid undercalling a lesion that is a dysplastic nevus or a melanoma as a nevus of special sites, because in this circumstance a patient could lose the opportunity either for surveillance to recognize a developing melanoma at an early, curable stage, or for definitive treatment of an established malignancy. In this monograph, dysplastic nevi and nevi of special sites are compared and contrasted in relation to melanoma.

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Cutaneous Melanomas Associated With Nevi

Abstract: To determine the frequency of and the histologic and clinical factors associated with melanoma existing in histologic contiguity with a nevus.

Cited by 230 publications

References 28 publications

Sun exposure and host phenotype as predictors of cutaneous melanoma associated with neval remnants or dermal elastosis

Sun exposure and host phenotype as predictors of cutaneous melanoma associated with neval remnants or dermal elastosis

Testing the divergent pathway hypothesis for melanoma: recent findings and future challenges

Precursors to melanoma and their mimics: nevi of special sites

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