Annals of Surgical Oncology Sign the Guestbook
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
10.1245/ASO.2005.03.022
Annals of Surgical Oncology 12:207-213 (2005)
© 2005 Society of Surgical Oncology
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Hawkins, W. G.
Right arrow Articles by Brady, M. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hawkins, W. G.
Right arrow Articles by Brady, M. S.

Original Article

Desmoplastic Melanoma: A Pathologically and Clinically Distinct Form of Cutaneous Melanoma

William G. Hawkins, MD1, Klaus J. Busam, MD2, Leah Ben-Porat, MS2, Katherine S. Panageas, PhD2, Daniel G. Coit, MD2, David E. Gyorki, MD2, David C. Linehan, MD1 and Mary S. Brady, MD2

1 Department of Surgery, Washington University, 660 S. Euclid Avenue, St. Louis, Missouri 63110
2 Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, New York 10021

Correspondence: Address correspondence and reprint requests to: Mary S. Brady, MD; E-mail: bradym{at}mskcc.org.

Background: Desmoplastic melanoma (DM) is a rare variant characterized by the presence of fusiform melanocytes in a sclerotic stroma. Pathologic heterogeneity within DM may account for the controversy regarding the clinical presentation and prognosis of DM compared with conventional melanoma (CM).

Methods: We identified 131 patients with a diagnosis of DM seen between 1979 and 2002. Tumors were categorized as either pure DM (pDM; n = 92), if desmoplasia was prominent throughout the entire invasive tumor, or mixed DM (mDM; n = 39), if fibrosis was well developed in only parts of an otherwise non-DM. Differences in clinical behavior among pDM, mDM, and CM (n = 3976) were examined.

Results: Seventy-three percent of patients with DM had tumors >2 mm in depth, compared with 31% of patients with CM (P < .001). Regional nodal metastasis was uncommon in patients who presented with clinically localized pDM (1%) compared with those with mDM (10%) or CM (6%) (P < .05, pDM vs. CM). Five-year melanoma-specific mortality was lower for patients who presented with pDM compared with mDM (11% vs. 31%; P < .01). Patients with pDM and CM had a similar melanoma-specific mortality despite a 3-fold difference in median tumor depth (3.6 vs. 1.2 mm, respectively).

Conclusions: DMs can be divided into two subtypes based on a histological quantification of desmoplasia. Tumors with prominent fibrosis (pure subtype) are unlikely to disseminate to regional lymph nodes and are associated with a favorable outcome when compared with those with mixed desmoplasia or CM.

Key Words: Desmoplastic melanoma • Lymph node • Survival • Recurrence




This article has been cited by other articles:


Home page
 Arch DermatolHome page
T. N. Helm and K. F. Helm
More Evidence for a New Melanoma Paradigm
Arch Dermatol, July 1, 2008; 144(7): 946 - 947.
[Full Text] [PDF]

Home page
 Mayo Clin Proc.Home page
S. N. Markovic, L. A. Erickson, R. D. Rao, R. R. McWilliams, L. A. Kottschade, E. T. Creagan, R. H. Weenig, J. L. Hand, M. R. Pittelkow, B. A. Pockaj, et al.
Malignant Melanoma in the 21st Century, Part 1: Epidemiology, Risk Factors, Screening, Prevention, and Diagnosis
Mayo Clin. Proc., March 1, 2007; 82(3): 364 - 380.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2005 by the Society of Surgical Oncology.