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BAP1-Inactivated Melanocytic Tumors With Distinctive p16-Negative Clonal Growth and Liver Metastases
Benjamin A Wood1,2, Sarah Shepard3, Craig James3
1PathWest Laboratory Medicine, J Block, QEII Medical Centre, Perth, Western Australia, Australia.
The American Journal of Dermatopathology
|November 14, 2025
Summary
BAP1-inactivated melanocytic tumors (BIMT), often appearing concerning, usually behave benignly. However, rare cases show malignant progression with metastasis, suggesting a distinct pathway.
Area of Science:
- Oncology
- Dermatopathology
- Genetics
Background:
- BAP1-inactivated melanocytic tumor (BIMT) is a melanocytoma subtype linked to BAP1 tumor suppressor gene inactivation.
- Histologic features can mimic malignancy, yet most BIMTs exhibit benign clinical behavior.
Purpose of the Study:
- To describe two rare cases of cutaneous BIMT with a specific morphologic pattern.
- To investigate the potential for malignant progression in BIMT.
Main Methods:
- Histopathologic examination of cutaneous BIMT.
- Analysis of p16 loss and clonal expansion.
- Clinical follow-up for locoregional recurrence and distant metastasis.
Main Results:
- Two cases of cutaneous BIMT demonstrated clonal expansion with p16 loss.
- Both cases experienced liver metastasis following complete surgical excision.
- No locoregional recurrence was observed in either case.
Conclusions:
- These cases suggest a distinct malignant progression pathway in BIMT.
- BIMT, despite its typical benign course, can rarely metastasize.
- Further research is needed to understand BIMT's malignant potential.
