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Desmoplastic melanoma: A review

Published:December 26, 2012DOI:https://doi.org/10.1016/j.jaad.2012.10.041
      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 nonmelanocytic 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 DM and nondesmoplastic melanoma. This has led to the separation of DM into 2 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.

      Key words

      Abbreviations used:

      DM (desmoplastic melanoma), LMM (lentigo maligna melanoma), LN (lymph node), mDM (mixed desmoplastic melanoma), NDM (neurotropic desmoplastic melanoma), OS (overall survival), pDM (pure desmoplastic melanoma), SEER (Surveillance, Epidemiology, and End Results), SLN (sentinel lymph node), SLNB (sentinel lymph node biopsy), SSM (superficial spreading melanoma)
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