Melanoma classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.; Serge Korjian M.D.

Overview

Melanoma may be classified into either cutaneous or non-cutaneous melanomas. The most common 4 sub-types of cutaneous melanoma include superficial spreading melanoma, nodular melanoma, acral lentiginous melanoma, and lentigo maligna melanoma. Less common sub-types of melanoma include desmoplastic/spindle cell melanoma, nevoid melanoma, spitzoid melanocytic melanoma, angiotropic melanoma, blue nevus-like melanoma, and composite melanoma.

Classification of Melanoma

Shown below is a table that demonstrates the various sub-classes of melanoma:[1][2]

Subtype Frequency Clinical Features
Common Subtypes
Superficial spreading melanoma 70%
  • Most common sub-type
  • Usually affects sun exposed sites among both men and women aged 50-70 years
  • Characterized by the presence of abundant junctional intra-epidermal spread of malignant melanocytes
Nodular melanoma 15-25%
  • Second most common subtype
  • Usually affects sun exposed sites among both men and women aged 50-70 years
  • Characterized by the absence of junctional intra-epidermal spread of malignant melanocytes
Acral lentiginous melanoma 5%
Lentigo maligna melanoma 1-5%
Non-cutaneous melanoma 5%
Less Common Subtypes
Desmoplastic/Spindle cell melanoma Rare
  • Lesion typically amelanotic and has a morphology similar to a scar tissue
  • Appears indolent but is highly infiltrative
  • Characterized by local recurrence and perineural spread
  • Usually affects males aged 60-70 years in sun exposed sites
  • May be de novo or can be associated with a pre-existing melanoma
  • Has several subtypes:
Nevoid melanoma Rare
Spitzoid melanocytic neoplasm Rare
Angiotropic melanoma Rare
Blue nevus-like melanoma Rare
  • Melanoma that develops from a pre-existing blue nevus
  • One of the rarest forms of melanoma
  • Appears as a blue nevus that has recently been rapidly expanding with irregular contours
  • Typically affects middle-aged men
Composite melanoma Rare

References

  1. Schanderdorf D, Kochs C, Livingstone E (2013). Handbook of Cutaneous Melanoma: A Guide to Diagnosis and Treatment. Springer.
  2. Mooi W, Krausz T (2007). Pathology of Melanocytic Disorders 2nd Ed. CRC Press.

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