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American Journal of Clinical Dermatology Nov 2018This review presents the main challenges encountered when diagnosing unusual variants of malignant melanoma with the aim of raising awareness to allow application of the... (Review)
Review
This review presents the main challenges encountered when diagnosing unusual variants of malignant melanoma with the aim of raising awareness to allow application of the most appropriate treatment strategies. Although these melanomas are often rare, their misdiagnosis potentially jeopardizes patients' health and survival, and has medicolegal implications. The clinical and histologic presentations of melanoma vary greatly, and assessment of uncommon melanomas can be difficult for practitioners because of their scarcity and resemblance to other dermatologic entities. The most problematic melanoma types are desmoplastic melanoma, polypoid melanoma, primary dermal melanoma, verrucous malignant melanoma, pigmented epithelioid melanocytoma, mucosal melanoma, follicular melanoma and melanoma with non-melanocytic differentiation. The two most difficult-to-diagnose subtypes of melanoma are the nevoid and the amelanotic melanomas. Some specific attributes of these variants can be more easily recognized with digital dermatoscopy, facilitating early detection and possibly avoiding invasive procedures. Key cases with the most notable clinical, dermatoscopic, and histopathologic features are presented, highlighting the practical issues of making an accurate diagnosis and choosing the best therapy.
Topics: Clinical Decision-Making; Dermoscopy; Diagnosis, Differential; Disease Progression; Humans; Melanoma; Microscopy, Confocal; Prognosis; Skin; Skin Neoplasms; Survival Rate
PubMed: 30374898
DOI: 10.1007/s40257-018-0373-6 -
Veterinary Sciences Apr 2022Canine melanocytic neoplasms have a highly variable biological behavior ranging from benign cutaneous melanocytomas to malignant oral melanomas that readily metastasize... (Review)
Review
Canine melanocytic neoplasms have a highly variable biological behavior ranging from benign cutaneous melanocytomas to malignant oral melanomas that readily metastasize to lymph nodes and internal organs. This review focuses on the diagnosis and prognosis of canine melanocytic neoplasms. While pigmented melanocytic neoplasms can be diagnosed with fine-needle aspirates, an accurate prognosis requires surgical biopsy. However, differentiating amelanotic spindloid melanomas from soft tissue sarcomas is challenging and often requires immunohistochemical labeling with a diagnostic cocktail that contains antibodies against Melan-A, PNL-2, TRP-1, and TRP-2 as the current gold standard. For questionable cases, RNA expression analysis for TYR, CD34, and CALD can further differentiate these two entities. The diagnosis of amelanotic melanomas will be aided by submitting overlying and/or lateral flanking epithelium to identify junctional activity. Wide excision of lateral flanking epithelium is essential, as lentiginous spread is common for malignant mucosal melanomas. Combining histologic features (nuclear atypia, mitotic count, degree of pigmentation, level of infiltration, vascular invasion; tumor thickness and ulceration) with the Ki67 index provides the most detailed prognostic assessment. Sentinel lymph nodes should be evaluated in cases of suspected malignant melanomas using serial sectioning of the node combined with immunohistochemical labeling for Melan-A and PNL-2.
PubMed: 35448673
DOI: 10.3390/vetsci9040175 -
Acta Medica Portuguesa Jun 2021
Topics: Diagnosis, Differential; Humans; Melanoma, Amelanotic; Skin Neoplasms
PubMed: 33861192
DOI: 10.20344/amp.13044 -
Ugeskrift For Laeger Jul 2021Pyogenic granuloma, also known as lobular capillary haemangioma, is a common benign vascular proliferation of not yet fully understood aetiology. Pyogenic granuloma can...
Pyogenic granuloma, also known as lobular capillary haemangioma, is a common benign vascular proliferation of not yet fully understood aetiology. Pyogenic granuloma can occur in all age groups and affect both men and women. Although pyogenic granuloma is a benign lesion, differential diagnosis may include malignant tumours such as amelanotic melanoma, basal cell carcinoma and spindle cell tumour. Surgical excision with primary closure is the usual treatment for pyogenic granuloma/lobular capillary haemangioma and has the lowest rate of recurrence.
Topics: Diagnosis, Differential; Female; Granuloma, Pyogenic; Humans; Male; Melanoma; Neoplasm Recurrence, Local; Skin Neoplasms
PubMed: 34356018
DOI: No ID Found -
Journal Der Deutschen Dermatologischen... Jun 2014Amelanotic melanoma is a subtype of cutaneous melanoma without pigment. The clinical diagnosis is challenging because it may mimic benign or malignant melanocytic and... (Review)
Review
Amelanotic melanoma is a subtype of cutaneous melanoma without pigment. The clinical diagnosis is challenging because it may mimic benign or malignant melanocytic and non-melanocytic neoplasms and inflammatory skin diseases. In synchrony with the improvement of the diagnosis of pigmented lesions, dermatoscopy may assist the clinician in the diagnosis of non-pigmented skin neoplasms in general and of amelanotic melanoma in particular. We have searched the literature to extract the most relevant dermatoscopic clues to diagnose amelanotic and hypomelanotic melanomas by dermatoscopy. In addition we present eight consecutive cases and discuss their clinical and dermatoscopic characteristics in the light of published data.
Topics: Dermoscopy; Diagnosis, Differential; Humans; Melanoma, Amelanotic; Skin; Skin Diseases; Skin Neoplasms
PubMed: 24825465
DOI: 10.1111/ddg.12368 -
BMJ Case Reports Mar 2011Schwannomas located in the eye are extremely rare and mainly arise from ciliary nerves. Ocular schwannoma usually present in the choroid, ciliary body or rarely sclera...
Schwannomas located in the eye are extremely rare and mainly arise from ciliary nerves. Ocular schwannoma usually present in the choroid, ciliary body or rarely sclera as a benign solitary amelanotic lesions. A 41-year-old woman presented with a history of decreased vision in her right eye of 3 months duration. She had an amelanotic lesion in the nasal side of left fundus. After all work-ups, malignant melanoma was suspected and enucleation was done. In clinicopathologic examination, findings were in favour of intrascleral schwannoma. Despite new modern diagnostic modalities, there are still some fundus lesions that are easily mistaken for amelanotic melanoma. Diagnostic procedures such as fine needle aspiration should be considered for equivocal lesions in the fundus that are not definitely diagnosed before surgery.
Topics: Adult; Eye Neoplasms; Female; Humans; Neurilemmoma; Sclera
PubMed: 22707621
DOI: 10.1136/bcr.07.2010.3158 -
Ugeskrift For Laeger Apr 2023In this case report, a 62-year-old woman was diagnosed with lymph node metastasis from melanoma in the groin. Initially the primary tumour was unknown. The entire skin...
In this case report, a 62-year-old woman was diagnosed with lymph node metastasis from melanoma in the groin. Initially the primary tumour was unknown. The entire skin was examined without any suspicious moles. A PET-CT scan showed an area on the left heel with increased activity. The element surprisingly showed an amelanotic melanoma. Amelanotic melanomas have a significantly worse prognosis compared to pigmented melanomas, presumably because they are detected later and may be very difficult to detect clinically. This case shows the importance of paying attention to unpigmented elements when searching for a primary tumour.
Topics: Female; Humans; Middle Aged; Melanoma, Amelanotic; Positron Emission Tomography Computed Tomography; Skin Neoplasms; Prognosis; Diagnosis, Differential
PubMed: 37114579
DOI: No ID Found -
Pediatric Health, Medicine and... 2017The purpose of this review is to outline recent advancements in diagnosis, treatment, and prevention of pediatric melanoma. Despite the recent decline in incidence, it... (Review)
Review
The purpose of this review is to outline recent advancements in diagnosis, treatment, and prevention of pediatric melanoma. Despite the recent decline in incidence, it continues to be the deadliest form of skin cancer in children and adolescents. Pediatric melanoma presents differently from adult melanoma; thus, the traditional asymmetry, border irregularity, color variegation, diameter >6 mm, and evolution (ABCDE) criteria have been modified to include features unique to pediatric melanoma (amelanotic, bleeding/bump, color uniformity, de novo/any diameter, evolution of mole). Surgical and medical management of pediatric melanoma continues to derive guidelines from adult melanoma treatment. However, more drug trials are being conducted to determine the specific impact of drug combinations on pediatric patients. Alongside medical and surgical treatment, prevention is a central component of battling the incidence, as ultraviolet (UV)-related mutations play a central role in the vast majority of pediatric melanoma cases. Aggressive prevention measures targeting sun safety and tanning bed usage have shown positive sun-safety behavior trends, as well as the potential to decrease melanomas that manifest later in life. As research into the field of pediatric melanoma continues to expand, a prevention paradigm needs to continue on a community-wide level.
PubMed: 29388632
DOI: 10.2147/PHMT.S115534 -
GE Portuguese Journal of... Sep 2021
PubMed: 34604472
DOI: 10.1159/000512090