Uncommon Histopathological Variants of Malignant Melanoma. Part 2

Saggini, Andrea; Cota, Carlo; Lora, Viviana; Kutzner, Heinz; Rütten, Arno; Sangüeza, Omar P.; Requena, Luis; Cerroni, Lorenzo

doi:10.1097/dad.0000000000001226

Cited by 20 publications

(25 citation statements)

References 120 publications

(221 reference statements)

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“…It is not possible to draw conclusions about the prognostic significance of the histological variant described here because of the low number of reported cases, all of which show very different behaviors 3,8 . However, chondrosarcomatous differentiation may be present in the primary tumor or arise in the metastatic lesions, as in this case 14 …”

Section: Discussionmentioning

confidence: 85%

“…Among the histopathological patterns of melanoma, chondrosarcomatous is very rare 3 . Few cases of pure chondrosarcomatous melanoma have been described in the literature 10,11 .…”

Section: Discussionmentioning

confidence: 99%

“…The mechanisms involved in the acquisition of different histological patterns and their clinical and prognostic significance are still unclear. It has been proposed that differentiation could represent a host response to injury 3 . In fact, most of the reported cases of cartilaginous differentiation seem to have, as common feature, a previous traumatic event, which could drive fibroblasts to cartilaginous differentiation.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the ten different melanoma categories recognized by the WHO classification of tumors, 1 many other histological variants have been described (recently reviewed 2,3 ). Accurate diagnosis and classification of these other variants is important for improving patient management.…”

Section: Introductionmentioning

confidence: 99%

“…Chondrosarcomatous is an unusual histopathological variant of melanoma in which osteoid and chondroid metaplasia (ranging from purely osteoid/chondroid differentiation to a mixture of both) is detected in either the primary or the metastatic lesion 3 . Melanomas with chondrosarcomatous differentiation are more common in acral locations, such as the subungual areas of toes and fingers, although cases with mucosal (nose, mouth, and vagina) and cutaneous onset (face, back, shoulder, ankle) have also been described 8 …”

Section: Introductionmentioning

confidence: 99%

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BRAF‐mutated malignant melanoma with chondrosarcomatous differentiation in inguinal nodal metastasis

Abbati

Altimari

Corti

et al. 2021

Clinical Case Reports

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Section: Discussionmentioning

confidence: 85%

“…Among the histopathological patterns of melanoma, chondrosarcomatous is very rare 3 . Few cases of pure chondrosarcomatous melanoma have been described in the literature 10,11 .…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

BRAF‐mutated malignant melanoma with chondrosarcomatous differentiation in inguinal nodal metastasis

Abbati

Altimari

Corti

et al. 2021

Clinical Case Reports

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Dermoscopy of Uncommon Melanoma Variants—Perspective From the Pathologist

Miller

Wanat

2020

JAMA Dermatol

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The article by Pampena et al 1 describes 10 rare melanoma variants. Their systematic review highlights the challenging nature of diagnosing melanomas with atypical clinical and dermoscopic features, with a wide differential diagnosis that often includes nonmelanocytic tumors and inflammatory conditions.This systematic review also highlights the complex and evolving nature of melanoma classification, which has traditionally been based on histopathologic and clinical features but more recently also incorporates genomic alterations. 2,3 Many rare variants of melanoma have been described that often defy classification among the traditional major subtypes. By definition, these variants have atypical clinical or histopathologic features, and based on the current study, many may also exhibit unique dermoscopic patterns.The primary traditional subtypes of invasive melanoma include superficial spreading, nodular, lentigo maligna, and acrallentiginous melanoma. These longstanding groups exist to reflect differences in tumor progression and biological behavior based on clinical observations and distinct microscopic features. The characteristic dermoscopic features of these subtypes are well described. Because our understanding of the genetics of melanoma has markedly expanded over the last decade, melanoma subtype classification is in flux. The most recent edition of the World Health Organization Classification of Skin Tumours 2 presents a new classification scheme that attempts to incorporate genomic alterations with existing diagnostic criteria and histopathologic features to better reflect multiple unique tumor progression pathways beyond the conventional "big 4." Among the 10 uncommon variants in-

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Clinical and Dermoscopic Features Associated With Difficult-to-Recognize Variants of Cutaneous Melanoma

et al. 2020

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The clinical and dermoscopic features of the vast majority of uncommon variants of cutaneous melanoma have been rarely reported, leading to difficulty in making accurate diagnoses.OBJECTIVE To define the main clinical and dermoscopic features of the most frequently reported but uncommon histologic variants of cutaneous melanoma.EVIDENCE REVIEW A 2-step systematic review of the literature was performed (from inception to November 2018) using PubMed, Embase, and Cochrane Central Register of Controlled Trials databases. The first step identified those uncommon variants of melanoma for which at least 1 case reporting dermoscopy was described in the literature. The keywords searched were melanoma, uncommon, rare, dermoscopy, and dermatoscopy. In the second step, each previously identified uncommon variant was searched for in the same databases by combining the following terms with melanoma, dermoscopy, and dermatoscopy: amelanotic, hypopigmented, animal, melanocytoma, balloon, desmoplastic, follicular, nested, nevoid, dermal, spitz*, spindle, and verrucous. The institution's database was also searched from January 2012 to September 2019 for histopathologically confirmed cases of the same melanoma variants. Each reviewer also assessed the quality of reporting in the included articles based on previously described guidelines.FINDINGS In total, 62 articles met the inclusion criteria, reporting 433 melanoma cases. An additional 56 cases of uncommon melanoma variants were retrieved from the institution's database for a total of 489 cases: 283 cases of amelanotic superficial spreading melanoma, 18 cases of animal-type and pigmented epithelioid melanocytoma, 7 cases of balloon cell melanoma, 71 cases of desmoplastic melanoma, 3 cases of follicular melanoma, 10 cases of nested melanoma, 33 cases of nevoid melanoma, 2 cases of primary dermal melanoma, 57 cases of spitzoid melanoma, and 5 cases of verrucous melanoma. These variants of melanoma occurred more frequently in women than men (147 cases vs 132 cases). Clinically, these tumors were mainly palpable (162 of 217 [74.7%]) or amelanotic (283 of 489 [57.9%]) lesions that could resemble other benign or malignant skin conditions; dermoscopy typically revealed a homogeneous pinkish background, white structures, and polymorphic vessels. The mean age of all included was 58 years (range, 1-89 years).CONCLUSIONS AND RELEVANCE Uncommon melanoma variants may resemble both inflammatory disorders and other cutaneous neoplasms, representing a diagnostic pitfall even for the most experienced dermatologist. The purpose of this systematic review was to provide an extensive and detailed overview of specific clinical and dermoscopic features of each uncommon melanoma variant, highlighting the main criteria for differentiating these variants from other benign or malignant skin lesions.

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Uncommon Histopathological Variants of Malignant Melanoma. Part 2

Cited by 20 publications

References 120 publications

BRAF‐mutated malignant melanoma with chondrosarcomatous differentiation in inguinal nodal metastasis

BRAF‐mutated malignant melanoma with chondrosarcomatous differentiation in inguinal nodal metastasis

Dermoscopy of Uncommon Melanoma Variants—Perspective From the Pathologist

Clinical and Dermoscopic Features Associated With Difficult-to-Recognize Variants of Cutaneous Melanoma

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