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Small malignant melanomas: clinicopathologic correlation and DNA ploidy analysis.
1Department of Dermatology, New York University Medical Center, NY 10016.
Journal of the American Academy of Dermatology
|June 1, 1990
Summary
Small malignant melanomas, even those under 6 mm, can exhibit aggressive features. These small melanomas share characteristics with larger ones, including histologic criteria, DNA abnormalities, and metastatic potential.
Area of Science:
- Dermatopathology
- Oncology
- Genetics
Background:
- Melanoma diagnosis often relies on lesion size, with >6 mm suggesting malignancy.
- Benign nevi are typically smaller than 6 mm.
- The accuracy of size as a sole criterion for melanoma is questioned.
Purpose of the Study:
- To evaluate melanomas measuring less than 6 mm in diameter.
- To assess if small melanomas share features with larger malignant melanomas.
- To determine the diagnostic and prognostic implications of small melanoma size.
Main Methods:
- Retrospective clinicopathologic study of 30 melanocytic proliferations <6 mm.
- Histologic criteria assessment for melanoma diagnosis.
- Multiparameter flow cytometry for DNA ploidy analysis.
- Clinical data review for sex ratio, race, anatomic sites, and outcomes.
Main Results:
- 19 of 30 cases met all 15 histologic criteria for malignant melanoma.
- 11 cases met 14 of 15 criteria.
- 4 of 8 analyzed small melanomas were aneuploid.
- Clinical presentation and biologic potential (metastasis, recurrence) were similar to larger melanomas.
Conclusions:
- Malignant melanomas <6 mm can possess histologic, genetic, and clinical features of larger lesions.
- Lesion size alone is insufficient for differentiating benign from malignant melanocytic neoplasms.
- Early detection and accurate histologic assessment are crucial for small melanomas.