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Desmoplastic melanoma: patterns of recurrence
B M Smithers1, G R McLeod, J H Little
1Princess Alexandra Hospital, Queensland Melanoma Project, University of Queensland, Brisbane, Australia.
World Journal of Surgery
|March 1, 1992
Summary
Desmoplastic melanoma, including its neural variants, often presents on the head and neck and can be amelanotic. While locally advanced, survival may be favorable compared to thicker melanomas.
Area of Science:
- Dermatology
- Oncology
- Pathology
Background:
- Desmoplastic melanoma (DM) is a rare malignant melanoma subtype.
- It encompasses variants like neural transforming melanoma and neurotropic melanoma.
- DM often presents as amelanotic lesions, particularly on the head and neck.
Purpose of the Study:
- To examine the pathology and clinical features of DM and its variants.
- To assess patterns of recurrent disease in patients with DM.
- To compare recurrence rates and survival outcomes of DM with other melanoma types.
Main Methods:
- Retrospective review of 58 patients with desmoplastic, neural transforming, or neurotropic melanoma.
- Analysis of tumor location, pigmentation, associated superficial melanoma, and histologic patterns.
- Evaluation of local recurrence, malignant cranial neuropathies, and disseminated disease.
Main Results:
- The tumor was located on the head and neck in 41% and amelanotic in 71% of patients.
- Local recurrence occurred in 29% of patients; 19% died from disseminated disease.
- Neurotropic melanomas showed lower visceral recurrence; DM and neural transforming melanomas had similar recurrence rates.
Conclusions:
- DM appears locally advanced with higher local recurrence rates than general melanoma.
- Survival for DM is comparable or more favorable than for thicker, non-desmoplastic melanomas.
- Wide surgical margins, close follow-up, and awareness of cranial nerve involvement are recommended.