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Intraneural Melanoma Identified With MART-1 Immunostaining in Mohs Micrographic Surgery
S Caleb Freeman1, Nicole N Dacy2, Brett C Neill3
1Dermatology, Oregon Health & Science University, Portland, USA.
Cureus
|May 27, 2024
Summary
Mohs micrographic surgery with MART-1 immunostaining effectively identified neurotropic melanoma invading nerves. This technique aids in precise tumor margin assessment for challenging facial, ear, or acral melanomas, reducing recurrence risk.
Area of Science:
- Dermatology
- Surgical Oncology
- Immunohistochemistry
Background:
- Mohs micrographic surgery (MMS) is used for cosmetically sensitive areas.
- Neurotropic melanoma invades nerves, posing a risk of recurrence due to unclear margins.
- Melanoma antigen recognized by T-cells (MART-1) is a key melanoma marker.
Observation:
- A case of neurotropic melanoma presented a diagnostic challenge.
- The tumor extended beyond apparent clinical margins.
- MART-1 immunostaining was employed during MMS.
Findings:
- MMS with MART-1 immunostaining successfully identified neurotropic melanoma.
- The immunostaining highlighted melanoma cell invasion into nerves.
- Confirmation was achieved through permanent section analysis.
Implications:
- MART-1 immunostaining enhances MMS accuracy for neurotropic melanoma.
- This method improves detection of subclinical spread in challenging locations.
- It offers a potential strategy to minimize local recurrence rates.
