Molecular testing in melanoma for the surgical pathologist

Area of Science:

• Pathology
• Molecular Diagnostics
• Dermatology

Background:

• Melanocytic tumor diagnosis is evolving rapidly due to advances in molecular assays.
• Pathologists face challenges navigating the increasing number of available molecular tests.
• Molecular tests offer valuable insights into melanoma treatment response, prognosis, and tumor classification.

Purpose of the Study:

• To provide an updated overview of key molecular ancillary tests used in clinical practice for melanocytic pathology.
• To help practicing pathologists understand and utilize the growing array of molecular diagnostic tools.
• To categorize molecular tests based on their clinical application in melanocytic lesions.

Main Methods:

• Review of current literature on molecular assays in melanocytic pathology.
• Categorization of molecular tests into four main clinical applications.
• Synopsis of major molecular ancillary tests for clinical use.

Main Results:

• Molecular tests are broadly categorized into four groups: predicting therapy response, prognosis, tumor type, and aiding in nevus versus melanoma differentiation.
• These tests are crucial for diagnosing histologically ambiguous melanocytic lesions.
• An updated synopsis of clinically relevant molecular tests is presented.

Conclusions:

• Molecular ancillary tests are indispensable tools in modern melanocytic pathology.
• Understanding these tests aids in accurate diagnosis, prognosis, and therapeutic decisions for melanoma.
• This review serves as a practical guide for pathologists managing melanocytic tumors.