Re: Zembowicz A, Carney JA, Mihm MC. Pigmented epithelioid melanocytoma: a low-grade melanocytic tumor with metastatic potential indistinguishable from animal-type melanoma and epithelioid blue nevus. Am J Surg Pathol. 2004;28:31–40

Zembowicz, Artur; Carney, J. Aidan; Mihm, Martín C.

doi:10.1097/01.pas.0000132741.04597.d6

Cited by 107 publications

(215 citation statements)

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“…Only 24 of 40 patients in that series underwent lymph node biopsies, however, suggesting that this grouping of lesions included those known or thought most likely to have no metastatic potential. 84 In an earlier study, seven of 10 patients with pigment-synthesizing tumors who underwent sentinel lymph node biopsies were found to have metastatic tumor deposits. 85 Follow-up, as in any case of invasive malignant melanoma, should be conducted.…”

Section: Management and Prognosismentioning

confidence: 99%

Unusual variants of malignant melanoma

2006

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A potential diagnostic pitfall in the histologic assessment of melanoma is the inability to recognize unusual melanoma variants. Of these, the more treacherous examples include the desmoplastic melanoma, the nevoid melanoma, the so-called 'minimal-deviation melanoma,' melanoma with prominent pigment synthesis or 'animal-type melanoma,' and the malignant blue nevus. Also problematic are the unusual phenotypic profiles seen in vertical growth phase melanomas; these include those tumors whose morphological peculiarities mimic cancers of nonmelanocytic lineage and those melanomas that express aberrant antigenic profiles not commonly associated with a melanocytic histogenesis. Metaplastic change in melanoma, balloon cell melanoma, signet-ring cell melanoma, myxoid melanoma, small cell melanoma and rhabdoid melanoma all have the potential to mimic metastatic and primary neoplasms of different lineage derivations. Abnormal immunohistochemical expression of CD 34, cytokeratins, epithelial membrane antigen, and smooth muscle markers as well as the deficient expression of S100 protein and melanocyte lineage-specific markers such as GP100 protein (ie HMB-45 antibody) and A103 (ie Melan-A) also present confusing diagnostic challenges. In this review, we will discuss in some detail certain of these novel clinicopathologic types of melanoma, as well as the abnormal phenotypic expressions seen in vertical growth phase melanoma. Modern Pathology (2006) 19, S41-S70. doi:10.1038/modpathol.3800516Keywords: melanoma; variants; phenotype; immunohistochemistry; morphology Desmoplastic melanoma Introduction and Clinical FeaturesDemoplastic melanoma is a rare variant of malignant melanoma first recognized in 1971.1 Desmoplastic and neurotropic melanoma may be mistaken clinically for a scar, a fibroma, a basal cell carcinoma, or a fibromatosis. Sometimes there is pronounced mucin deposition that imparts a boggy quality to the lesion. 2,3 The clinical clue to the diagnosis, when present, is cutaneous or mucosal pigmentation overlying a palpable dermal or submucosal nodule. That said, only half of desmoplastic melanomas are clinically pigmented. 3 Desmoplastic melanomas tend to occur in the head and neck area and the upper back [4][5][6][7] but are also seen in mucosal sites such as the vulva or gingiva 8 and in acral locations. Typically, they occur in older patients, with mean ages in the larger series falling into the sixth to eighth decades of life. 4,6,[9][10][11][12][13][14][15] Larger series show a male preponderance of 1.75 to 1. 15 Although any given desmoplastic melanoma can be deeply invasive, when matched for depth of invasion, they are associated with a lesser risk of metastatic disease than conventional melanomas of similar depth. The classical clinical finding is that of a pale or fleshy firm nodule reminiscent of a scar, which tends to delay clinical diagnosis and biopsy. Carlson et al,6 who reported an equal distribution in men and women, found most tumors to be located in the head and neck area (75%) and to be nonpigment...

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Section: Management and Prognosismentioning

confidence: 99%

Unusual variants of malignant melanoma

2006

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“…Tal variante faz parte de subgrupo que se caracteriza por proliferação tumoral de melanócitos com síntese exuberante de pigmento (6) . Alguns autores preferem o termo "melanocitoma epitelioide pigmentado" para designar os casos de tumores melanocíticos borderlines ou melanomas de baixo grau, como nevo azul epitelioide e melanoma do tipo animal (2,3,12) . Estudos com avaliação genética mostram que o melanoma do tipo animal observado no homem difere do correspondente à doença melanocítica de equinos.…”

Section: Discussionunclassified

“…Em humanos, não há predileção por etnia, sexo ou local (2,12) e não há casos descritos na mucosa oral (4) . A maioria dos pacientes tem menos de 30 anos, sugerindo incidência maior na população mais jovem (6,8) .…”

Section: Discussionunclassified

“…O melanoma tipo animal é constituído por proliferação celular dérmica profunda (média da medida da espessura de Breslow de 3,3 mm), observando-se melanócitos epitelioides ou fusiformes densamente pigmentados (12) . Infiltração pagetoide e hiperplasia da epiderme podem ser observadas (6) .…”

Section: Discussionunclassified

“…A população de célu-las fusiformes está comumente disposta em fascículos e as células epitelioides ou poligonais dispõem-se em arranjo nodular (6) . A atividade mitótica é muito pequena, a resposta inflamatória do hospedeiro é mínima, a invasão intravascular não é observada (6) e ulceração e necrose ocorrem em raros casos (12) . Requena et al (9) descreveram um caso com áreas de regressão na junção dermoepidérmica e na derme papilar, o que é incomum.…”

Section: Discussionunclassified

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nbsp; language=pt]Melanoma tipo animal: relato de dois casos

Marques

Yamashita²,

Marques³

et al. 2010

J. Bras. Patol. Med. Lab.

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Dificuldade potencial no diagnóstico histológico de melanomas é a dificuldade em reconhecer variantes pouco frequentes de melanoma. Entre elas, as mais desafiantes incluem exemplos de melanoma desmoplásico, melanoma nevoide, o chamado "melanoma de desvio mínimo", melanomas com proeminente síntese de pigmento ou "melanoma tipo animal" e o nevo azul maligno. Os autores descrevem dois casos de melanoma tipo animal e discute-se a importância do diagnóstico diferencial clinico-histopatológico nesses casos.

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