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Desmoplastic melanoma: a diagnostic trap for the unwary 

Authors: Stanley W. McCarthy abc;  Richard A. Scolyer abc; A. Allan Palmer a
Affiliations:   a Department of Anatomical Pathology,
b Sydney Melanoma Unit,
c Melanoma and Skin Cancer Research Institute, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
DOI: 10.1080/00313020412331285336
Publication Frequency: 7 issues per year
Published in: journal Pathology, Volume 36, Issue 5 October 2004 , pages 445 - 451
Subject: Pathology;
Number of References: 59
Formats available: PDF (English)
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Abstract

Desmoplastic melanoma (DM) is an uncommon type of spindle cell melanoma in which the malignant cells are separated by collagen fibres or fibrous stroma. DM is prone to misdiagnosis because of unfamiliarity with its often bland appearance and dissimilarity to other conventional types of melanoma. It displays variable cytological atypia, cellularity and stromal fibrosis and more often than not has an accompanying atypical junctional component. Neurotropism is a common associated feature (in at least 30% of cases) and when it occurs such tumours are termed 'desmoplastic neurotropic melanomas' (DNM). The neurotropism may be perineural or intraneural and often extends beyond the desmoplastic component. In addition, some DMs show evidence of neural differentiation ('neural transformation'). DM may also present as a recurrence or occasionally as a metastasis from other types of melanoma. A high index of suspicion and knowledge of its often subtle morphological appearance are necessary to avoid misdiagnosis.
Keywords: Desmoplasia; desmoplastic melanoma; desmoplastic neurotropic melanoma; melanoma; nevus; naevus; neurotropism; pathology; spindle cell melanoma
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