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Desmoplastic neurotropic malignant melanoma
1Department of Pathology, School of Medicine, University of California, San Francisco, USA.
Pathology (Philadelphia, Pa.)
|January 1, 1994
Summary
Desmoplastic neurotropic malignant melanoma, a rare spindle cell melanoma, presents unique diagnostic and therapeutic challenges. This review covers its clinical, histologic, and immunohistochemical features for accurate identification and management.
Area of Science:
- Oncology
- Dermatopathology
Background:
- Desmoplastic neurotropic malignant melanoma (DNMM) is an uncommon variant of melanoma.
- It is characterized by spindle-shaped cells and a prominent desmoplastic stroma.
- DNMM often exhibits neurotropism, with tumor cells infiltrating peripheral nerves.
Purpose of the Study:
- To provide a comprehensive review of desmoplastic neurotropic malignant melanoma.
- To elucidate its distinct clinical and pathological characteristics.
- To discuss diagnostic challenges and therapeutic strategies.
Main Methods:
- Review of clinical case presentations.
- Histopathological analysis including routine H&E staining.
- Immunohistochemical evaluation for melanocytic and neural markers.
- Ultrastructural examination via electron microscopy.
Main Results:
- DNMM typically presents as a firm, often amelanotic nodule or plaque.
- Histologically, it shows atypical spindle cells in a desmoplastic stroma with perineural invasion.
- Immunohistochemistry is crucial, with positive staining for S100 and SOX10, and variable Melan-A/MART-1 expression.
Conclusions:
- Accurate diagnosis of DNMM requires integration of clinical, histological, and immunohistochemical findings.
- Distinguishing DNMM from other spindle cell neoplasms is critical for appropriate treatment.
- Management of DNMM involves consideration of its aggressive potential and neurotropic behavior.