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 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 47" - "Export Date: 24 October 2012" - "CODEN: ASONF" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work