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Desmoplastic melanoma: a clinico-pathological review
V S Devaraj1, A L Moss, J C Briggs
1Department of Plastic Surgery, Frenchay Hospital, Bristol.
British Journal of Plastic Surgery
|November 1, 1992
Summary
Desmoplastic melanoma (DM) is a rare skin cancer with frequent recurrence and metastasis. Early aggressive surgery is crucial for this aggressive tumor, especially for head and neck lesions.
Area of Science:
- Dermatology
- Oncology
- Pathology
Background:
- Desmoplastic melanoma (DM) is a rare histological variant of melanoma.
- Limited clinical experience exists for DM, often reported in isolated case studies.
- DM is characterized by a high incidence of local recurrence and nodal metastases.
Purpose of the Study:
- To review clinical experience with desmoplastic melanoma (DM).
- To analyze recurrence patterns and outcomes in DM patients.
- To highlight the need for early aggressive surgical intervention in DM.
Main Methods:
- Retrospective review of 13 patients diagnosed with DM over 20 years.
- Analysis of patient demographics, lesion characteristics, and treatment outcomes.
- Evaluation of recurrence rates, sites of metastasis, and survival data.
Main Results:
- The mean age of presentation was 67 years, with 2/3 of lesions on the head and neck.
- Average tumor thickness (Breslow) was 5.78 mm.
- Seven patients experienced recurrence (4 regional nodes, 3 skin nodules), with 4 developing disseminated disease and 3 deaths.
Conclusions:
- Desmoplastic melanoma (DM) demonstrates a high propensity for recurrence and metastasis.
- Aggressive surgical management is indicated for DM, particularly for head and neck presentations.
- DM requires vigilant follow-up due to significant risk of advanced disease and mortality.