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Updated: Mar 26, 2026
A 3D Organotypic Melanoma Spheroid Skin Model
Published on: May 18, 2018
Desmoplastic Melanoma
1Department of Pathology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA; Weill Medical College of Cornell University, New York, NY, USA.
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) is a rare spindle cell melanoma variant often misdiagnosed due to indistinct 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 spindle cell melanoma variant with abundant fibrous matrix.
- Typically affects head and neck on sun-damaged skin in older individuals.
- Clinical and histological features are often indistinct, leading to misdiagnosis.
Purpose of the Study:
- To characterize the clinical presentation, histology, immunophenotype, and behavior of desmoplastic melanoma.
- To differentiate DM from similar-appearing lesions.
- To understand DM's distinct clinical course.
Main Methods:
- Review of clinical and histopathological features of DM cases.
- Immunohistochemical analysis for melanocytic markers (e.g., S-100, melanocyte differentiation antigens).
- Comparison of DM with conventional melanoma regarding recurrence and metastasis rates.
Main Results:
- DM presents with abundant fibrous stroma, often mimicking other lesions.
- Immunophenotypically, DM is typically S-100 positive but may show weak or absent melanocytic antigen expression.
- DM exhibits a higher rate of local recurrence but a lower rate of regional lymph node metastasis.
Conclusions:
- Desmoplastic melanoma requires careful clinical and histological evaluation due to its potential for misdiagnosis.
- Its unique immunophenotype and clinical behavior distinguish it from conventional melanoma.
- Understanding these differences is crucial for appropriate patient management and prognosis.
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