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Melanocytic Lesions
Published in Ashfaq A Marghoob, Ralph Braun, Natalia Jaimes, Atlas of Dermoscopy, 2023
Natalia Jaimes, Juergen F. Kreusch, Giuseppe Argenziano, Scott W. Menzies
Amelanotic melanoma accounts for at least 2–8% of all melanomas and represents an important diagnostic challenge for clinicians. Amelanotic melanomas frequently lack the clinical features seen in superficial spreading melanomas, such as asymmetry, irregular borders, and color variegation (i.e., ABC criteria); and they can mimic inflammatory entities, as well as other benign and malignant tumors. The term amelanotic melanoma is frequently employed as a clinical description for any melanoma lacking melanin pigmentation. However, to be more precise, there are amelanotic and hypomelanotic melanomas. Pure amelanotic melanomas do not produce any discernable eumelanin, whereas hypomelanotic melanomas produce low levels of eumelanin at least in certain sections of the tumor.
Special site melanoma (mucosal, acral)
Published in Longo Caterina, Diagnosing the Less Common Skin Tumors, 2019
Oral melanomas usually present on the hard palate, maxillary gingiva and lips. Most patients are in the seventh decade. The clinical presentation of tumors is variable, from macular to ulcerated and nodular painless mass, often bleeding. The colors vary from black to gray to purple to red to white, and they can be variably arranged. Pigmented lesions from 1 to 10 mm or larger can be found, and reports of previously existing pigmented lesions are common. Amelanotic melanoma cases are also reported, and in these cases a misdiagnosis is frequent. The differential diagnosis for intraoral melanotic lesions includes mucosal melanoma, amalgam tattoo, melanotic macule, oral mucosal nevi and melanoacanthoma.
Morphologic and Hemodynamic Alterations in Capillaries During Hyperthermia
Published in Leopold J. Anghileri, Jacques Robert, Hyperthermia in Cancer Treatment, 2019
Bernhard Endrich, Frithjof Hammersen
The experimental model used here provides a possibility to warm up the amelanotic melanoma in a well-controlled manner. For the measurement of local temperature, the coverglass within the chamber frame was removed and the preparation was kept moist by superfusion at the temperature niveau given by the protocol. With this heating technique, the deviation of temperature inside the tumor was lower than 0.5°C with no difference between the center and the periphery of the melanoma under study.
Matched analysis of the prognosis of amelanotic and pigmented melanoma in head and neck
Published in Acta Oto-Laryngologica, 2020
Wei Guo, Gaofei Yin, Hongfei Liu, Hanyuan Duan, Zhigang Huang, Xiaohong Chen
Mucosal melanoma is a rare malignant tumour type. Head and neck mucosal melanoma accounts for about 40% of mucosal melanoma [1], and the 5-year survival rate is less than 20% [2]. At present, the clinical diagnosis and treatment of mucosal melanoma are still under investigation, so it is necessary to study the stratification of this special tumour type. In addition to the type of location, melanoma can be classified into amelanotic melanoma (AM) and pigmented melanoma according to the absence or presence of pathological cytoplasmic melanin granules. Due to the low incidence of AM and the diversity of morphologies, it is easy to misdiagnose benign and malignant tumours. This not only increases the difficulty of clinical treatment, but also affects the prognosis of patients with different types of tumour. To explore the influence of this special type of head and neck mucosal melanoma on clinical prognosis, we analyzed data from patients with amelanotic and pigmented melanoma at our center.
The use of in vivo reflectance confocal microscopy for the diagnosis of melanoma
Published in Expert Review of Anticancer Therapy, 2019
Marina Agozzino, Elvira Moscarella, Graziella Babino, Stefano Caccavale, Vincenzo Piccolo, Giuseppe Argenziano
Epidermal and dermal structures identified with in vivo confocal images are comparable to histology. The first consensus of terminology glossary with illustrative images was published in 2007 with descriptions and definitions of image quality, normal skin morphology, lesional architecture, and cellular details of melanocytic lesions [9]. Research mainly focused on skin cancers, including the differentiation of benign and malignant skin lesions [10–16]. In 2012, Guitera et al. [11] used RCM and dermoscopy to detect melanoma with a sensitivity of 98% and determined that biopsies of benign nevi and lesions clinically suspicious for BCC could be reduced by as much as 68% in a series of 710 equivocal lesions [11]. In 2014, in a prospective study including more than 1000 patients, Pellacani et al. [8]. demonstrated that biopsies of equivocal benign lesions were reduced by more than 50%, and all of the melanomas and BCCs excised in the study were correctly detected by RCM interpretation [8]. Additionally, in both studies, the sensitivity of the RCM interpretation for detecting BCC was 100%. Amelanotic melanoma can be diagnostically challenging because clinical and dermoscopic features are usually nonspecific. In 2001, Busam et al. [12] successfully used RCM for amelanotic melanoma detection and margin assessment [12]. A subsequent study by Braga et al. [13] demonstrated that RCM may aid in the detection and diagnosis of various solitary pink lesions [13]. The improvement in diagnostic accuracy of RCM with light-colored lesions may be explained by the fact that even small quantities of melanin would appear bright under RCM, and hence the atypical melanocytes will be highlighted. Similarly, Alarcon et al. [14] showed that diagnostic sensitivity for melanoma detection is similar for RCM (98%) and dermoscopy (95%), while RCM markedly increased specificity (RCM 92% versus dermoscopy 27%) [14].