Acral lentiginous melanoma : conventional histology vs. three-dimensional histology

摘要: Summary Background  Patients with acral lentiginous melanoma (ALM) seem to have a poor prognosis. ALMs represent 4–10% of cutaneous melanomas in white populations. Surgery is mostly based on conventional histological evaluation. With micrographic surgery, continuously spreading tumours can be excised smaller excision margins for better cosmesis and function. Objectives  Clinical parameters surgical strategies influencing the prognosis patients ALM were evaluated. Methods  Two hundred forty-one (44% male, 56% female) stage I/II recorded during 1980–2006. One thirty-three underwent complete histology three-dimensional (3D histology) using paraffin technique. Risk factors disease-specific recurrence-free survival estimated. Results  aged 26–87 years (median 63) median tumour thickness 2·0 mm. The follow-up was 41 months. Multivariate analysis identified ulceration, as risk survival. Using 3D histology, significantly 7 vs. 20 mm) without an increased local recurrences. had 5-year 81% compared 63% histology. Retrospective immunohistological methods (anti-Melan-A) could improve diagnostic specificity detecting further melanocytic cell nests. Conclusions  different influences outcome ALM. allows reduction by two-thirds recurrences immunohistology valuable tool reduce rate