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Desmoplastic Melanoma Masquerading as Neurofibroma
Evan Stokar1, Carlos Rodriguez1, Jerry Feldman1
1Drs. Stokar and Feldman are from the Division of Dermatology, John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois. Dr. Rodriguez is from Arrowhead Dermatology, Phoenix, Arizona.
Cutis
|July 21, 2021
Summary
Desmoplastic melanoma (DMM) is a rare cancer that is difficult to diagnose. Early biopsy of suspicious lesions is crucial for accurate diagnosis and improved outcomes.
Area of Science:
- Dermatology
- Oncology
- Pathology
Background:
- Desmoplastic melanoma (DMM) is a rare and diagnostically challenging variant of melanoma.
- Its clinical and histological features can mimic benign or other malignant neoplasms, leading to misdiagnosis.
Observation:
- A case of DMM presenting as a pink papule on the neck is described.
- Initial low-power histopathology suggested a neurofibroma.
- Higher-power examination and immunohistochemistry confirmed DMM.
Findings:
- DMM poses significant diagnostic challenges for both clinicians and pathologists.
- Histological features can be deceptive, resembling benign spindle cell tumors.
- Immunohistochemical staining is essential for accurate diagnosis.
Implications:
- Prompt biopsy of new or changing lesions in at-risk individuals (older males, head/neck location) is critical.
- Increased awareness of DMM's varied presentation is needed to improve early detection.
- Accurate diagnosis is vital for appropriate management and to reduce DMM-specific mortality risk.
