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Primary malignant melanoma with pseudovascular morphology: a diagnostic pitfall
Monia Di Prete1, Paola Pasquini1, Elisa Melucci2
1Dermatopathology Research Unit, San Gallicano Dermatological Institute IRCCS, Rome.
Dermatology Reports
|November 19, 2025
Summary
This study describes a rare variant of nodular melanoma with a unique pseudovascular appearance, termed retiform melanoma. Accurate diagnosis requires integrating clinical, morphological, and molecular findings to differentiate it from other tumors.
Area of Science:
- Dermatopathology
- Oncology
- Surgical Pathology
Background:
- Melanoma exhibits diverse clinical and histopathological presentations.
- Unusual melanoma morphologies can be misdiagnosed as non-melanocytic tumors.
- Accurate histopathological evaluation is crucial for melanoma diagnosis.
Purpose of the Study:
- To present a case of nodular melanoma with a distinctive pseudovascular morphology.
- To propose the term 'retiform melanoma' for this variant.
- To emphasize the importance of integrated diagnostic approaches for rare melanoma types.
Main Methods:
- Histopathological examination of the neoplasm.
- Immunohistochemical analysis.
- Ancillary molecular testing.
Main Results:
- A case of nodular melanoma with pseudovascular morphology, featuring empty branching slit-like spaces resembling rete testis vessels, was identified.
- The proposed name 'retiform melanoma' distinguishes it from angiomatoid melanoma.
- Immunohistochemistry and molecular tests aided in characterizing the neoplasm.
Conclusions:
- Retiform melanoma is a rare variant of nodular melanoma with distinctive morphology.
- Distinguishing retiform melanoma from other tumors requires careful clinicopathological correlation.
- Integrated clinical-morphological-molecular assessment is essential for diagnosing unusual melanoma cases.
