Desmoplastic melanoma: A review

Abstract

Desmoplastic melanoma (DM) is a variant of spindle cell melanoma typically found on chronically sun-damaged skin of older individuals. Early diagnosis can be challenging because it is often amelanotic and has a predominantly dermal component. DM can be difficult to diagnose not only clinically but also histologically, and can be mistaken for a variety of benign and malignant non-melanocytic spindle cell tumors when viewed on prepared histopathology slides. Pathologists have observed that DMs can manifest significant variation with respect to the extent of intratumoral cellularity, fibrosis and/or perineural invasion. Furthermore, some tumors present with a pure desmoplastic invasive component (>90%) while other tumors display mixed features of desmoplastic and non-desmoplastic melanoma. This has lead to the separation of DM into two histologic subtypes, pure and mixed. With a focus on the distinction between pure and mixed DM, this review will detail what is currently known about the diagnostic features of DM, discuss risk and prognostic factors and examine the current literature on disease progression and management.

The Genetic Evolution of Melanoma from Precursor Lesions

“…S8 in Supplementary Appendix 1), a biologically distinct subtype of melanoma that is associated with high cumulative sun exposure and characterized by sarcomatous growth patterns. 27 The earliest detectable pathogenic mutation was a homozygous splicesite mutation of NF1 that was already present in the in situ area, and progression to desmoplastic melanoma coincided with homozygous loss of CDKN2A and PTEN. There were numerous point mutations reflective of ultraviolet radiation, a finding that is consistent with the high sun exposure associated with most desmoplastic melanomas.…”

Desmoplastic melanoma in a fingertip: A rare entity

“…2,3 It exhibits a strong reaction in the actual lesion, but can still be found in the scar already cleared of melanoma. 3 Confusingly the Se100 stain is also positive in schwannomata and other nerve tumours. 3 Histological findings in our case included fibroblastic reaction but no melanocytic hyperplasia, so our first tissue diagnosis was misinterpreted as scar.…”

“…3 Confusingly the Se100 stain is also positive in schwannomata and other nerve tumours. 3 Histological findings in our case included fibroblastic reaction but no melanocytic hyperplasia, so our first tissue diagnosis was misinterpreted as scar. It stained for the Se100 at the later histological examination, which helped to diagnose DM.…”

B16 cell lysates plus polyinosinic-cytidylic acid effectively eradicate melanoma in a mouse model by acting as a prophylactic vaccine

“…Malignant melanoma is a serious disease arising from melanocytes which threatens human health in China and worldwide (1,2). The incidence and mortality rate of malignant melanoma continues to increase at a higher rate than that of any other type of malignancy (3,4).…”