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Updated: Jun 2, 2026
A 3D Organotypic Melanoma Spheroid Skin Model
Published on: May 18, 2018
Desmoplastic melanoma
1Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. busamk@mskcc.org
Abstract:
Desmoplastic melanoma (DM) is a variant of spindle cell melanoma characterized by the presence of abundant fibrous matrix. It is typically found in the head and neck region on chronically sun-damaged skin of older individuals. Early detection is uncommon, because its clinical features are not distinctive. DM is prone to misdiagnosis not only clinically but also histologically. It may simulate a sclerosing melanocytic nevus and various benign and malignant nonmelanocytic lesions. Among melanomas said to be desmoplastic by various pathologists there is significant variation with regard to the extent of intratumoral fibrosis. It may be prominent throughout the entire tumor (pure DM) or represent a portion of an otherwise nondesmoplastic melanoma (combined DM). Immunophenotypically, DM are usually strongly and homogeneously positive for S-100 protein, but are often negative or only focally positive for melanocyte differentiation antigens. DM differs from conventional melanoma in its clinical course. It is associated with a higher tendency for local recurrence, but metastases to regional lymph nodes are less common.
Insights
Desmoplastic melanoma (DM), a rare spindle cell cancer, presents challenges in early detection and diagnosis due to its subtle clinical and histological features. While prone to local recurrence, it shows a lower risk of lymph node metastasis compared to conventional melanoma.
Area of Science:
- Dermatology
- Oncology
- Pathology
Background:
- Desmoplastic melanoma (DM) is a rare variant of spindle cell melanoma.
- It is characterized by abundant fibrous matrix and typically affects sun-damaged skin on the head and neck in older individuals.
- DM often presents with indistinct clinical features, complicating early detection.
Purpose of the Study:
- To describe the key characteristics of desmoplastic melanoma.
- To highlight diagnostic challenges and differential diagnoses.
- To outline the distinct clinical behavior of DM compared to conventional melanoma.
Main Methods:
- Review of clinical and histological features of desmoplastic melanoma.
- Immunophenotypic analysis including S-100 protein and melanocyte differentiation antigens.
- Comparison of clinical course, including recurrence and metastasis rates, with conventional melanoma.
Main Results:
- DM exhibits significant intratumoral fibrosis, ranging from pure DM to combined forms.
- Immunophenotypically, DM is typically S-100 positive but often negative for other melanocyte markers.
- DM shows a higher rate of local recurrence but a lower incidence of regional lymph node metastasis.
Conclusions:
- Desmoplastic melanoma presents unique diagnostic challenges, mimicking benign nevi and nonmelanocytic lesions.
- Its immunophenotype and clinical behavior differ from conventional melanoma.
- Understanding these distinctions is crucial for accurate diagnosis and management of DM.
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