Melanoma classification: Difference between revisions
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{{CMG}} {{AE}} {{YD}}; {{SSK}} | {{CMG}} {{AE}} {{YD}}; {{SSK}} | ||
==Overview== | ==Overview== | ||
Melanoma may be classified into either cutaneous or non-cutaneous melanomas. The most common 4 | [[Melanoma]] may be classified into either [[Skin|cutaneous]] or [[Skin|non-cutaneous]] [[Melanoma|melanomas]]. The most common 4 sub-types of [[Skin|cutaneous]] [[melanoma]] include [[Superficial (human anatomy)|superficial]] spreading [[melanoma]], [[Nodule (medicine)|nodular]] [[melanoma]], [[acral lentiginous melanoma]], and [[lentigo maligna melanoma]]. Less common sub-types of [[melanoma]] include [[Desmoplasia|desmoplastic]]/[[spindle cell]] [[melanoma]], [[nevoid melanoma]], [[Spitzoid melanoma|spitzoid melanocytic melanoma]], [[angiotropic melanoma]], [[blue nevus]]-like [[melanoma]], and [[composite melanoma]]. | ||
==Classification of Melanoma== | ==Classification of Melanoma== | ||
Shown below is a table that demonstrates | Shown below is a table that demonstrates the various sub-classes of [[melanoma]]:<ref name="book1">{{cite book|last=Schanderdorf D, Kochs C, Livingstone E |date=2013 |title=Handbook of Cutaneous Melanoma: A Guide to Diagnosis and Treatment |publisher=Springer }}</ref><ref name="book2">{{cite book|last=Mooi W, Krausz T|date=2007 |title=Pathology of Melanocytic Disorders 2nd Ed. |publisher=CRC Press}}</ref> | ||
{| {{table}} | {| {{table}} cellpadding="4" cellspacing="0" style="border:#c9c9c9 1px solid; margin: 1em 1em 1em 0; border-collapse: collapse;" | ||
| align="center" style="background: #4479BA;" | {{fontcolor|#FFF|'''Subtype'''}} | | align="center" style="background: #4479BA;" | {{fontcolor|#FFF|'''Subtype'''}} | ||
| align="center" style="background: #4479BA;" | {{fontcolor|#FFF|'''Frequency'''}} | | align="center" style="background: #4479BA;" | {{fontcolor|#FFF|'''Frequency'''}} | ||
| align="center" style="background: #4479BA;" | {{fontcolor|#FFF|'''Clinical Features'''}} | | align="center" style="background: #4479BA;" | {{fontcolor|#FFF|'''Clinical Features'''}} | ||
|- | |- | ||
|colspan=3|'''''Common Subtypes''''' | | colspan="3" |'''''Common Subtypes''''' | ||
|- | |- | ||
|Superficial spreading melanoma||70%|| | |[[Superficial (human anatomy)|Superficial]] spreading [[melanoma]]||70%|| | ||
*Most common | *Most common sub-type | ||
*Usually affects sun exposed sites among both men and women aged 50-70 years | *Usually affects sun exposed sites among both men and women aged 50-70 years | ||
*Characterized by ''presence'' of abundant junctional | *Characterized by the ''presence'' of abundant junctional [[Epidermis (skin)|intra-epidermal]] spread of [[malignant]] [[Melanocyte|melanocytes]] | ||
|- | |- | ||
|Nodular melanoma||15-25%|| | |[[Nodular melanoma]]||15-25%|| | ||
*Second most common subtype | *Second most common subtype | ||
*Usually affects sun exposed sites among both men and women aged 50-70 years | *Usually affects sun exposed sites among both men and women aged 50-70 years | ||
*Characterized by ''absence'' of junctional | *Characterized by the ''absence'' of junctional [[Epidermis (skin)|intra-epidermal]] spread of [[malignant]] [[Melanocyte|melanocytes]] | ||
|- | |- | ||
|Acral lentiginous melanoma||5%|| | |[[Acral lentiginous melanoma]]||5%|| | ||
*Not associated with chronic ultraviolet exposure | *Not associated with [[Chronic (medical)|chronic]] [[ultraviolet]] exposure | ||
*Affects the extremities | *Affects the [[Limb (anatomy)|extremities]] of individuals of all [[Race|races]] | ||
*Common among elderly Caucasian and non- | *Common among the elderly Caucasian and non-Caucasian individuals | ||
|- | |- | ||
|Lentigo maligna melanoma||1-5%|| | |[[Lentigo maligna melanoma]]||1-5%|| | ||
*Preceded by lentigo maligna | *Preceded by [[lentigo maligna]] | ||
*Common among elderly Caucasian patients | *Common among the elderly Caucasian [[Patient|patients]] | ||
*Usually appears as a flat, non-palpable lesion that affects sun exposed sites, especially the head and neck (extremities are less common) | *Usually appears as a flat, non-palpable [[lesion]] that affects sun exposed sites, especially the [[head]] and [[neck]] ([[Lesion|lesions]] on [[Limb (anatomy)|extremities]] are less common) | ||
|- | |- | ||
| Non-cutaneous melanoma||5%|| | | [[Skin|Non-cutaneous]] [[melanoma]]||5%|| | ||
*Melanoma that does not affect the skin | *[[Melanoma]] that does not affect the [[skin]] | ||
*Usually affects the eye (ocular melanoma) or the mucus membranes (mucosal melanoma) | *Usually affects the [[eye]] ([[ocular]] [[melanoma]]) or the [[Mucous membrane|mucus membranes]] ([[Mucous membrane|mucosal]] [[melanoma]]) | ||
|- | |- | ||
| colspan=3| '''''Less Common Subtypes''''' | | colspan="3" | '''''Less Common Subtypes''''' | ||
|- | |- | ||
| Desmoplastic/Spindle cell melanoma||Rare|| | | [[Desmoplasia|Desmoplastic]]/[[Spindle cell]] [[melanoma]]||Rare|| | ||
*Lesion typically amelanotic and has a morphology similar to a scar tissue | *[[Lesion]] typically amelanotic and has a [[morphology]] similar to a [[scar tissue]] | ||
*Appears indolent but is highly infiltrative | *Appears indolent but is highly [[Infiltration (medical)|infiltrative]] | ||
*Characterized by local recurrence and perineural spread | *Characterized by local recurrence and [[Perineurium|perineural]] spread | ||
*Usually affects males aged 60-70 years in sun exposed sites | *Usually affects males aged 60-70 years in sun exposed sites | ||
*May be de novo or associated with a pre-existing melanoma | *May be [[de novo]] or can be associated with a pre-existing [[melanoma]] | ||
*Has several subtypes: | *Has several subtypes: | ||
::*Pure: paucicellular | ::*Pure: paucicellular | ||
::*Desmoplastic-neurotropic melanoma: characterized by neurotropism | ::*[[Desmoplasia|Desmoplastic]]-neurotropic [[melanoma]]: characterized by neurotropism | ||
::*Pure neurotropic melanoma: no desmoplasia with spindle cell melanoma of neurotropic phenotype | ::*Pure neurotropic [[melanoma]]: no [[desmoplasia]] with [[spindle cell]] [[melanoma]] of neurotropic [[phenotype]] | ||
::*Mixed/Combined: epithelial and spindle cells | ::*Mixed/Combined: [[Epithelium|epithelial]] and [[spindle cells]] | ||
|- | |- | ||
| Nevoid melanoma||Rare|| | | [[Nevoid melanoma]]||Rare|| | ||
*Lesion has features of both melanoma and melanocytic nevus on histopathological analysis | *[[Lesion]] has features of both [[melanoma]] and [[melanocytic nevus]] on [[Histopathology|histopathological]] [[analysis]] | ||
*Clinical features resemble those of typical melanoma | *Clinical features resemble those of a typical [[melanoma]] | ||
|- | |- | ||
| Spitzoid melanocytic neoplasm||Rare|| | | [[Spitzoid melanoma|Spitzoid melanocytic neoplasm]]||Rare|| | ||
*Lesion has features of both melanoma and Spitz (epithelioid) tumor | *[[Lesion]] has features of both [[melanoma]] and Spitz ([[epithelioid]]) [[tumor]] | ||
*Typically affects sun exposed sites among children and young adults, but adults with Spitz tumors are more often diagnosed with Spitzoid melanoma | *Typically affects sun exposed sites among children and young adults, but adults with Spitz [[Tumor|tumors]] are more often [[Diagnosis|diagnosed]] with [[Spitzoid melanoma]] | ||
*Compared to benign Spitz tumors, Spitzoid melanomas are usually large (>5 mm) | *Compared to [[benign]] Spitz [[Tumor|tumors]], [[Spitzoid melanoma|Spitzoid melanomas]] are usually large (>5 mm) | ||
|- | |- | ||
| Angiotropic melanoma||Rare|| | | [[Angiotropic melanoma]]||Rare|| | ||
*Lesion characterized by angiotropism, whereby melanoma grows in proximity (within 1-2 mm) to blood and/or lymphatic tissue but no tumor within the vascular lamina itself | *[[Lesion]] characterized by angiotropism, whereby the [[melanoma]] grows in proximity (within 1-2 mm) to [[blood]] and/or [[Lymphatic system|lymphatic tissue]] but no [[tumor]] within the [[vascular]] [[lamina]] itself | ||
*The tumor may originally be another | *The [[tumor]] may originally be another sub-type of [[melanoma]] | ||
*Clinical features similar to typical melanoma | *Clinical features similar to typical [[melanoma]] | ||
|- | |- | ||
| Blue nevus-like melanoma||Rare|| | | [[Blue nevus]]-like [[melanoma]]||Rare|| | ||
*Melanoma that develops from a pre-existing blue nevus | *[[Melanoma]] that develops from a pre-existing [[blue nevus]] | ||
*One of the rarest forms of melanoma | *One of the rarest forms of [[melanoma]] | ||
*Appears as a blue nevus that has recently been rapidly expanding with irregular contours | *Appears as a [[blue nevus]] that has recently been rapidly expanding with irregular contours | ||
*Typically affects middle-aged men | *Typically affects middle-aged men | ||
|- | |- | ||
| Composite melanoma||Rare|| | | [[Composite melanoma]]||Rare|| | ||
*Melanoma that develops in proximity | *[[Melanoma]] that develops in the proximity of other pre-existing [[Epithelium|epithelial]] [[Cancer|malignancies]] (e.g. [[Basal cell carcinoma|basal]]/[[squamous cell carcinoma]]) | ||
*May be characterized by one of the following: | *May be characterized by one of the following: | ||
::*Collision tumor: Collision of melanoma and another nearby malignant tumor | ::*Collision [[tumor]]: Collision of [[melanoma]] and another nearby [[malignant]] [[tumor]] | ||
::*Colonization: Colonization of melanocytes in a tumor | ::*Colonization: Colonization of [[Melanocyte|melanocytes]] in a [[tumor]] | ||
::*Combined: Two distinct tumors appear to have mixed features of the melanoma and the other tumor | ::*Combined: Two distinct [[Tumor|tumors]] appear to have mixed features of the [[melanoma]] and the other [[tumor]] | ||
::*Biphenotypic: One tumor that has features of melanoma and another epithelial malignancy | ::*[[Biphenotypic melanoma|Biphenotypic]]: One [[tumor]] that has features of [[melanoma]] and another [[Epithelium|epithelial]] [[Cancer|malignancy]] | ||
|} | |} | ||
Latest revision as of 01:44, 2 January 2019
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Melanoma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Melanoma classification On the Web |
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American Roentgen Ray Society Images of Melanoma classification |
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Risk calculators and risk factors for Melanoma classification |
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% |
|
| Nodular melanoma | 15-25% |
|
| Acral lentiginous melanoma | 5% |
|
| Lentigo maligna melanoma | 1-5% |
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| Non-cutaneous melanoma | 5% | |
| Less Common Subtypes | ||
| Desmoplastic/Spindle cell melanoma | Rare |
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| Nevoid melanoma | Rare |
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| Spitzoid melanocytic neoplasm | Rare |
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| Angiotropic melanoma | Rare | |
| Blue nevus-like melanoma | Rare |
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| Composite melanoma | Rare |
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