A tiny invasive melanoma: a case report with dermatoscopy and dermatopathology

Abstract

We present a case of an early invasive melanoma (Breslow thickness 0.25 mm), 1.6 mm in diameter on the arm of a 38-year-old woman. She was under surveillance due to having multiple (>100) nevi, and the melanoma was assessed as a new lesion by the examining doctor. Clinically the lesion was hyper-pigmented compared with surrounding nevi and dermatoscopically it had a clue of pseudopods/lines radial, but they were arranged in an arguably symmetrical circumferential pattern around a structureless blue-gray center. Generally melanomas are expected to be dermatoscopically asymmetrical, but we believe that this case illustrates the fact that small melanomas may be recognized by clues such as pseudopods/lines radial and dermatoscopic gray even when they have not yet developed unequivocal asymmetry.

Keywords: dermatopathology; dermatoscopy; dermoscopy; melanoma; small melanoma.

Figure 1.

(A) Clinical image and (B) dermatoscopic image of a new pigmented skin lesion on the arm of a 38-year-old woman. Radial lines/pseudopods are arranged circumferentially around a structureless blue-gray centre. Although radial lines/pseudopods are present in all quadrants of the periphery they are less numerous in the upper-left quadrant. Asymmetry is assessed as equivocal. [Copyright: ©2013 Pellizzari et al.]

Figure 2.

(A) Low power and (B, C) high power dermatopathologic images of the lesion shown in Figure 1. [Copyright: ©2013 Pellizzari et al.]