摘要: Desmoplastic melanoma (DM) is a fibrosing variant of spindle cell melanoma. It most often presents as an indurated lesion in chronically sun-damaged skin. Due to the lack characteristic clinical features, early detection uncommon. At time excision, tumors usually extend into reticular dermis or deeper. DM prone misdiagnosis. may simulate histologically sclerosing melanocytic nevi well various benign and malignant nonmelanocytic lesions. There significant morphologic variability among classified DM. Desmoplasia be prominent throughout entire tumor ("pure" DM) represent portion otherwise nondesmoplastic ("combined" DM). Some show neuroma-like features with nerve involvement, which case term "desmoplastic neurotropic melanoma" used. Immunophenotypically, DMs are strongly homogeneously positive for S-100 protein but negative only focally melanocyte differentiation antigens such tyrosinase, gp100, Melan-A, microphthalmia transcription factor. differs from conventional its course. associated higher tendency local recurrence, metastases regional lymph nodes less common. Evidence also emerging that patients thick melanomas, presence paucicellular histology (pure favorable prognostic factor survival.
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