Desmoplastic melanoma: report of 5 cases

Abstract

Background. The clinical presentation of desmoplastic melanoma is often challenging. We report the experience of the Melanoma Unit of Spedali Civili University Hospital of Brescia, Italy. Method. Study subjects were drawn from 1770 patients with histologica confirmed melanoma. Within this group, desmoplastic melanoma developed in 5 patients. For each diagnosed melanoma, histological characteristics, treatment, and outcomes were evaluated. Results. Of the 5 patients described in this study, 2 were males and 3 females. The average age was 62.4 years ranging from 56 to 68 years. Breslow thickness ranged from 2.1 to 12 mm with a mean thickness of 5.8 mm. Primary treatment of 5 patients included a wide local excision of their primary lesions. Conclusions. Desmoplastic melanoma is a rare neoplasm which clinically may mimic other tumours or cutaneous infiltrate of uncertain significance. The diagnosis is hiastopathological and radical resection is necessary.

Figure 1

Clinical appearance of desmoplastic melanoma (patient n°4): red plaque of 5 × 3 cm on left leg. The diagnoses that are suspected clinically range from basal cell carcinoma to dermatofibrosarcoma protuberans or amelanotic melanoma.

Figure 2

Desmoplastic melanoma: atypical spindle cells in a dense fibous matrix (haematoxylin and eosin; original magnification ×10).

Figure 3

Desmoplastic melanoma: S-100 immunoreactivity in the dermal spindle cells (original magnification ×10).