Desmoplastic melanoma: A pathologically and clinically distinct form of cutaneous melanoma Journal Article

Authors: Hawkins, W. G.; Busam, K. J.; Ben-Porat, L.; Panageas, K. S.; Coit, D. G.; Gyorki, D. E.; Linehan, D. C.; Brady, M. S.
Article Title: Desmoplastic melanoma: A pathologically and clinically distinct form of cutaneous melanoma
Abstract: Background: Desmoplastic melanoma (DM) is a rare variant characterized by the presence of fusiform melanocytes in a sclerotic stroma. Pathologic heterogeneity within DM may account for the controversy regarding the clinical presentation and prognosis of DM compared with conventional melanoma (CM). Methods: We identified 131 patients with a diagnosis of DM seen between 1979 and 2002. Tumors were categorized as either pure DM (pDM; n = 92), if desmoplasia was prominent throughout the entire invasive tumor, or mixed DM (mDM; n = 39), if fibrosis was well developed in only parts of an otherwise non-DM. Differences in clinical behavior among pDM, mDM, and CM (n = 3976) were examined. Results: Seventy-three percent of patients with DM had tumors >2 mm in depth, compared with 31% of patients with CM (P < .001). Regional nodal metastasis was uncommon in patients who presented with clinically localized pDM (1%) compared with those with mDM (10%) or CM (6%) (P < .05, pDM vs. CM). Five-year melanoma-specific mortality was lower for patients who presented with pDM compared with mDM (11% vs. 31%; P < .01). Patients with pDM and CM had a similar melanoma-specific mortality despite a 3-fold difference in median tumor depth (3.6 vs. 1.2 mm, respectively). Conclusions: DMs can be divided into two subtypes based on a histological quantification of desmoplasia. Tumors with prominent fibrosis (pure subtype) are unlikely to disseminate to regional lymph nodes and are associated with a favorable outcome when compared with those with mixed desmoplasia or CM. © 2005 The Society of Surgical Oncology, Inc.
Keywords: survival; adult; aged; middle aged; survival analysis; retrospective studies; major clinical study; clinical feature; comparative study; lymph node metastasis; melanoma; skin neoplasms; melanocytes; recurrence; pathology; histology; fibrosis; skin tumor; lymph node; desmoplastic melanoma
Journal Title: Annals of Surgical Oncology
Volume: 12
Issue: 3
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2005-03-01
Start Page: 207
End Page: 213
Language: English
DOI: 10.1245/aso.2005.03.022
PUBMED: 15827812
PROVIDER: scopus
Notes: --- - "Cited By (since 1996): 47" - "Export Date: 24 October 2012" - "CODEN: ASONF" - "Source: Scopus"
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MSK Authors
  1. Katherine S Panageas
    332 Panageas
  2. Mary Sue Brady
    168 Brady
  3. Daniel Coit
    427 Coit
  4. Klaus J Busam
    547 Busam
  5. David Emerk Gyorki
    8 Gyorki
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