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Bofan L, Xiaofei X, Jingwen Z, Zuzhuo Z, Tianxiao M, Feng G, Guochuan Z, Zhou Z. Neurosarcomatous amelanotic transformation of malignant melanoma presenting as malignant periopheral nerve sheath tumor: Rare case report. Medicine (Baltimore) 2023; 102:e34034. [PMID: 37352079 PMCID: PMC10289641 DOI: 10.1097/md.0000000000034034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/25/2023] [Accepted: 05/29/2023] [Indexed: 06/25/2023] Open
Abstract
RATIONALE Malignant melanoma (MM) is notorious for its remarkable morphological variation and aberrant histopathological patterns. In addition, Malignant Periopheral Nerve Sheath Tumor (MPNST) is an uncommon but aggressive soft tissue sarcoma. Because of the common embryological origin of melanocytes and Schwann cells in the neural crest, discriminating between a particular type of MM and MPNST can be difficult, particularly when they are amelanotic. Our goal is to increase awareness among clinicians of the rare variations of MM and the importance of medical history in improving the accuracy of the final clinical diagnosis. PATIENT CONCERNS A 68-year-old man was admitted to the hospital due to pain in his right ankle, which had persisted for 8 months, along with swelling for 4 months. Medical history revealed delayed healing of right plantar for 5 years after a traumatic injury. DIAGNOSES The ankle mass was initially diagnosed as MPNST through biopsy. After reviewing the patient's medical history and receiving the final pathological report following amputation, we have revised the diagnosis to metastatic amelanotic desmoplastic melanoma in the ankle part and lentigo maligna melanoma in the plantar part. This is due to both lesions displaying positive markers or mutated genes in immunohistology and Gene Mutation Detection, indicating homology between the 2 tumors. INTERVENTIONS Due to the malignant characteristics of the tumor and the patient's wishes, amputation of the right lower leg was carried out. OUTCOMES Subsequently, the patient was treated with interferon-γ and immunosuppressant PD-1 inhibitor, and survived for 1 year after amputation. LESSONS Clinical data, immunohistochemisty biomarkers and genes detection results can serve as valuable evidence for pathologists and clinicians in identifying the disease process. Collaborative efforts between clinicians and scientists are crucial in order to identify specific markers that can effectively differentiate between the 2 tumors, thereby enhancing the conclusiveness of the diagnosis.
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Affiliation(s)
- Lu Bofan
- Clinical medicine of Basic Medical College, HeBei Medical university, Shijiazhuang, Hebei, P. R. China
| | - Xiu Xiaofei
- Department of Pathology, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei, P. R. China
| | - Zhang Jingwen
- Department of Neurosurgery, The Second Hospital of Hebei Medical University, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Zhang Zuzhuo
- Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Ma Tianxiao
- Department of Orthopedic Oncology, Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Gao Feng
- Department of Pathology, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei, P. R. China
| | - Zhang Guochuan
- Department of Orthopedic Oncology, Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhuang Zhou
- Department of Orthopedic Oncology, Third Hospital of Hebei Medical University, Shijiazhuang, China
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Huayllani MT, Sisti A, Restrepo DJ, Boczar D, Cochuyt JJ, Spaulding AC, Bagaria SP, Rinker BD, Forte AJ. Desmoplastic Melanoma: Clinical Characteristics and Survival in the US Population. Cureus 2019; 11:e4931. [PMID: 31431837 PMCID: PMC6695240 DOI: 10.7759/cureus.4931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objective Desmoplastic melanoma (DM) is a rare variant of invasive malignancy of the skin pigmented cells. We present a comprehensive study reporting on US demographics, disease characteristics, and survival, to contribute to the current knowledge and raise awareness of this rare disease. Materials and methods The demographics of DM patients diagnosed from January 1, 2004, to December 31, 2015, were obtained by querying the National Cancer Database. The characteristics of DM were compared with common malignant melanoma (CMM) using univariate and multivariate regression models. Five-year overall survival (OS) curves were estimated using Kaplan-Meier analyses and the Cox proportional regression model. Results Our query found 5,895 patients diagnosed with DM and 292,939 patients with CMM. DM tended to present at an older age, a more advanced stage, and with a Breslow depth greater than 4 mm at diagnosis (P<.05). The Kaplan-Meier survival analysis demonstrated a five-year OS for DM and CMM of 75% and 76%, respectively, without any statistical difference (P=.07). Cox regression analysis demonstrated that age at diagnosis and comorbidities were independent predictors of five-year OS for DM (P<.001). Conclusions Older age, advanced stage, and higher Breslow depth were found to be independent positive factors associated with DM.
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Affiliation(s)
- Maria T Huayllani
- Plastic Surgery, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic Florida, Jacksonville, USA
| | - Andrea Sisti
- Plastic Surgery, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic Florida, Jacksonville, USA
| | - David J Restrepo
- Plastic Surgery, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic Florida, Jacksonville, USA
| | - Daniel Boczar
- Plastic Surgery, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic Florida, Jacksonville, USA
| | | | | | | | - Brian D Rinker
- Plastic Surgery, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic Florida, Jacksonville, USA
| | - Antonio J Forte
- Plastic Surgery, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic Florida, Jacksonville, USA
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Shi P, Xu Z, Lei X, Yibulayin F, Wushou A. Desmoplastic melanoma: Demographic and clinicopathological features and disease-specific prognostic factors. Oncol Lett 2019; 17:5619-5627. [PMID: 31186784 PMCID: PMC6507310 DOI: 10.3892/ol.2019.10259] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 03/14/2019] [Indexed: 01/19/2023] Open
Abstract
Desmoplastic melanoma (DM) is a rare morphological subtype of melanoma that remains uncharacterized. The aim of the present study was to investigate the incidence of DM, its general demographics, clinicopathological features and disease-specific prognostic factors. DM cases were sampled from the Surveillance, Epidemiology and End Results (SEER) program from between 1973 and 2017. A total of 3,657 cases (median age, 68 years) were identified. The results indicated that DM primarily occurred in Caucasian subjects, with a male-to-female ratio of 2:1. Statistically significant overall survival (OS) and disease-specific survival (DSS) rate differences were identified according to sex, age, treatment, T stage, N stage and SEER historic tumor stage (P<0.05). In multivariate Cox regression analysis, age >68 years, male sex, American Joint Committee on Cancer (AJCC) stage II and III, and SEER historic tumor stage of the regional tumor were all factors associated with poorer OS and DSS rates. The findings also revealed that surgical treatment was associated with favorable DSS and OS rates. In conclusion, DM occurred primarily in Caucasian subjects of 60–80 years of age, with predominance in males. Furthermore, age, sex, AJCC stage, SEER historic tumor stage and surgical treatment were identified as independent prognostic factors of DM in terms of DSS and OS.
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Affiliation(s)
- Ping Shi
- Department of Stomatology, Shenzhen Longhua District Central Hospital, Shenzhen, Guangdong 518110, P.R. China
| | - Zhe Xu
- Department of Stomatology, Shenzhen Longhua District Central Hospital, Shenzhen, Guangdong 518110, P.R. China
| | - Xin Lei
- Department of Stomatology, Shenzhen Longhua District Central Hospital, Shenzhen, Guangdong 518110, P.R. China
| | - Feiluore Yibulayin
- Department of Preventive Medicine, School of Public Health, Fudan University, Shanghai 200001, P.R. China
| | - Alimujiang Wushou
- Department of Oral and Maxillofacial Surgery, Shanghai Stomatological Hospital, Fudan University, Shanghai 200001, P.R. China
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Farnetani F, Manfredini M, Chester J, Ciardo S, Gonzalez S, Pellacani G. Reflectance confocal microscopy in the diagnosis of pigmented macules of the face: differential diagnosis and margin definition. Photochem Photobiol Sci 2019; 18:963-969. [DOI: 10.1039/c8pp00525g] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Here we review the state-of-the-art of RCM morphologic descriptors, standardized terminology, and diagnostic algorithms for the assessment of pigmented macules of the face, for their correct diagnosis and management.
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Affiliation(s)
- Francesca Farnetani
- Department of Surgical
- Medical
- Dental & Morphological Sciences with Interest Transplant
- Oncological & Regenerative Medicine
- Dermatology Unit
| | - Marco Manfredini
- Department of Surgical
- Medical
- Dental & Morphological Sciences with Interest Transplant
- Oncological & Regenerative Medicine
- Dermatology Unit
| | - Johanna Chester
- Department of Surgical
- Medical
- Dental & Morphological Sciences with Interest Transplant
- Oncological & Regenerative Medicine
- Dermatology Unit
| | - Silvana Ciardo
- Department of Surgical
- Medical
- Dental & Morphological Sciences with Interest Transplant
- Oncological & Regenerative Medicine
- Dermatology Unit
| | | | - Giovanni Pellacani
- Department of Surgical
- Medical
- Dental & Morphological Sciences with Interest Transplant
- Oncological & Regenerative Medicine
- Dermatology Unit
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Abstract
Desmoplastic melanoma (DM) and spindle cell melanoma (SCM) are 2 rare subtypes of melanoma. This study aims to investigate these 2 melanomas comprehensively by comparison.Cases were identified in the Surveillance, Epidemiology, and End Results (SEER) database (1973-2017).A total of 3657 DM and 4761 SCM cases were identified. DM's female-to-male ratio was 1:2 and SCM's was 0.62:1. The age distribution was similar. Both tumor mostly originated from skin and the eye and orbit was SCM-specific tumor site. Comparing both tumors with DM as reference, significant overall survival (OS) were found depending on sex (women, P < .001), age (age ≤65 years, P < .001), race (white, P = .01), tumor orientation (skin, P < .001), T stage (T3 + T4, P = .001), SEER historic stage (regional tumor, P = .04), and surgery (P = .01). Meanwhile, significant disease specific survival (DSS) differences were found depending on sex (men, P < .001), age (age ≤65 years, P < .001), race (white, P < .001), tumor orientation (skin, P < .001), T early stage (T1 + T2, P = .02), T advanced stage (T3 + T4 stage, P = .001), SEER historic stage (regional tumor, P < .001), and surgery (P < .001). The chance of DSS and OS of SCM were significantly higher comparing to DM for female patients (HR = 1.268, for OS; HR = 1.711, for DSS), patients age ≤65 years (HR = 1.290, for OS; HR = 1.638, for DSS), No-Spanish-Hispanic-Latino patients (HR = 1.098, for OS; HR = 1.426, for DSS), patients with skin tumor (HR = 1.174; for OS; HR = 1.444; for DSS) and patients who received surgery (HR = 1.091; for OS; HR = 1.398, for DSS).DM and SCM mostly occurred in white people' skin at 60 to 80 years old and eye and orbit was another most affected site for SCM. SCM had slightly higher occurrence in women and the risk of DSS and OS were significantly higher comparing to DM depending on the women, patients age ≤65 years, patients with skin tumor, No-Spanish-Hispanic-Latino patients and patients who received surgery.
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Affiliation(s)
- Zhe Xu
- Department of Stomatology, Shenzhen Longhua District Central Hospital, Shenzhen
| | | | - Ping Shi
- Department of Stomatology, Shenzhen Longhua District Central Hospital, Shenzhen
| | - Lei Feng
- Department of Oral and Maxillofacial Surgery, Shanghai Stomatological Hospital, Fudan University, Shanghai, P.R. China
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Machado I, Llombart B, Cruz J, Traves V, Requena C, Nagore E, Parafioriti A, Monteagudo C, Llombart-Bosch A. Desmoplastic melanoma may mimic a cutaneous peripheral nerve sheath tumor: Report of 3 challenging cases. J Cutan Pathol 2017; 44:632-638. [DOI: 10.1111/cup.12949] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 04/06/2017] [Accepted: 04/08/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Isidro Machado
- Department of Pathology; Instituto Valenciano de Oncología; Valencia Spain
| | - Beatriz Llombart
- Department of Dermatology; Instituto Valenciano de Oncología; Valencia Spain
| | - Julia Cruz
- Department of Pathology; Instituto Valenciano de Oncología; Valencia Spain
| | - Víctor Traves
- Department of Pathology; Instituto Valenciano de Oncología; Valencia Spain
| | - Celia Requena
- Department of Dermatology; Instituto Valenciano de Oncología; Valencia Spain
| | - Eduardo Nagore
- Department of Dermatology; Instituto Valenciano de Oncología; Valencia Spain
| | - Antonina Parafioriti
- Department of Pathology; ASST - Centro Specialistico Ortopedico Traumatologico Gaetano PINI - CTO; Milano Italy
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