Shifts in Cutaneous Melanocytic Tumor Diagnostic Terminology: Melanocytoma, MPATH-Dx V2.0 and the WHO Skin5

Lyn M Duncan¹, David E Elder², Michael W Piepkorn^{3

4}, Stevan R Knezevich⁵, Willeke A M Blokx⁶, Marcus Bosenberg⁷, Klaus J Busam⁸, Richard Carr⁹, Martin G Cook¹⁰, Pedram Gerami¹¹, Jennifer Ko¹², Gilles Landman¹³, Alexander J Lazar¹⁴, Lori Lowe¹⁵, Daniela Mihic-Probst¹⁶, Birgitta Schmidt¹⁷, Christopher R Shea¹⁸, Richard A Scolyer^{19

20

21

22}, Xiaowei Xu^{23

24}, Joann G Elmore²⁵, Raymond L Barnhill²⁶

Affiliations

¹ Harvard Medical School, Dermatopathology Unit, Pathology Service, Massachusetts General Hospital, Boston, Massachusetts, USA.
² Division of Anatomic Pathology, Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
³ Division of Dermatology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA.
⁴ Dermatopathology Northwest, Bellevue, Washington, USA.
⁵ Pathology Associates, Clovis, California, USA.
⁶ Division Laboratories, Department of Pathology, Pharmacy and Biomedical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands.
⁷ Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA.
⁸ Department of Pathology, Dermatopathology Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
⁹ Cellular Pathology, South Warwickshire NHS Trust, Warwick, UK.
¹⁰ Department of Histopathology, Royal Surrey NHS Foundation Trust, Guildford, UK.
¹¹ Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
¹² Department of Anatomic Pathology, Cleveland Clinic, Cleveland, Ohio, USA.
¹³ Department of Pathology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
¹⁴ Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
¹⁵ Department of Dermatology and Pathology, University of Michigan Medical School, Ann Arbor, Michigan, USA.
¹⁶ Institute for Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland.
¹⁷ Department of Pathology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
¹⁸ Department of Medicine, Section of Dermatology, University of Chicago, Chicago, Illinois, USA.
¹⁹ Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, and NSW Health Pathology, Sydney, New South Wales, Australia.
²⁰ Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
²¹ Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.
²² Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.
²³ Department of Pathology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
²⁴ Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
²⁵ Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, California, USA.
²⁶ Department of Translational Research, Institut Curie, Paris Sciences and Lettres Research University, and UFR of Medicine, University of Paris Cité, Paris, France.

PMID: 40181698
DOI: 10.1111/cup.14788

Review

Shifts in Cutaneous Melanocytic Tumor Diagnostic Terminology: Melanocytoma, MPATH-Dx V2.0 and the WHO Skin5

Lyn M Duncan et al. J Cutan Pathol. 2025.

. 2025 Apr 4.

doi: 10.1111/cup.14788. Online ahead of print.

Authors

Affiliations

¹ Harvard Medical School, Dermatopathology Unit, Pathology Service, Massachusetts General Hospital, Boston, Massachusetts, USA.
² Division of Anatomic Pathology, Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
³ Division of Dermatology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA.
⁴ Dermatopathology Northwest, Bellevue, Washington, USA.
⁵ Pathology Associates, Clovis, California, USA.
⁶ Division Laboratories, Department of Pathology, Pharmacy and Biomedical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands.
⁷ Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA.
⁸ Department of Pathology, Dermatopathology Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
⁹ Cellular Pathology, South Warwickshire NHS Trust, Warwick, UK.
¹⁰ Department of Histopathology, Royal Surrey NHS Foundation Trust, Guildford, UK.
¹¹ Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
¹² Department of Anatomic Pathology, Cleveland Clinic, Cleveland, Ohio, USA.
¹³ Department of Pathology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
¹⁴ Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
¹⁵ Department of Dermatology and Pathology, University of Michigan Medical School, Ann Arbor, Michigan, USA.
¹⁶ Institute for Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland.
¹⁷ Department of Pathology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
¹⁸ Department of Medicine, Section of Dermatology, University of Chicago, Chicago, Illinois, USA.
¹⁹ Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, and NSW Health Pathology, Sydney, New South Wales, Australia.
²⁰ Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
²¹ Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.
²² Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.
²³ Department of Pathology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
²⁴ Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
²⁵ Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, California, USA.
²⁶ Department of Translational Research, Institut Curie, Paris Sciences and Lettres Research University, and UFR of Medicine, University of Paris Cité, Paris, France.

PMID: 40181698
DOI: 10.1111/cup.14788

Abstract

In this Special Issue of the Journal of Cutaneous Pathology in memory of Dr. Martin C. Mihm, Jr, we highlight his many contributions over more than 50 years to the catalog of specific melanocytic tumor terminology. Dr. Mihm was an active participant in the International Melanoma Pathology Study Group (IMPSG). Discussions led to proposed recommendations for changes in the terminology of melanocytic tumors and their standardized diagnostic reporting. Histopathological reports of melanocytic tumors provide critical information that guides patient counseling and therapy. Importantly the pathology report must relay whether the melanocytic tumor is benign, intermediate, or malignant, and when appropriate, indicate diagnostic and/or prognostic uncertainty. Recent shifts in diagnostic terminology include the recommended use of the term "melanocytoma" to describe a morphologically and genetically defined subset of intermediate risk melanocytic tumors with higher (although still very low) risk of progression compared with benign nevi. Melanocytomas are distinguished from melanocytic tumors of uncertain malignant potential (MELTUMP) which are histopathologically indeterminate or uncertain tumors. In the setting of a broad lexicon for the reporting of melanocytic tumors, an assessment tool has been developed to map existing diverse terminologies into distinct hierarchical classes. The Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx) V2.0 provides a four-tiered classification scheme that is tiered by risk of tumor progression and recommended treatment. The purpose of this review is to report these shifts in diagnostic terminology, discussed and reviewed at the annual workshop of the IMPSG, in Edinburg, Scotland, in November 2022. This discussion included the use of the term melanocytoma, and the use of the MPATH-Dx V2.0 classification and terminology for melanocytic tumors. Dr. Mihm was diligent in his attention to specific terminology, in his memory we aim to recommend terminology that improves communication in the care of those diagnosed with melanocytic tumors.

Keywords: Spitz; melanocytoma; melanoma; nevus; terminology.

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References

1. WHO Classification of Skin Tumours Editorial Board, Skin Tumours. WHO Classification of Tumours Series, vol. 12, 5th ed. (International Agency for Research on Cancer, 2023), https://tumourclassification.iarc.who.int/chapters/64.
1. R. L. Barnhill, D. E. Elder, M. W. Piepkorn, et al., “Revision of the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis Classification Schema for Melanocytic Lesions: A Consensus Statement,” JAMA Network Open 6, no. 1 (2023): e2250613, https://doi.org/10.1001/jamanetworkopen.2022.50613.
1. D. Elder, R. Barnhill, and B. Bastian, eds., “Melanocytomas,” in WHO Classification of Tumours. Skin Tumours, 5th ed. (International Agency for Research on Cancer, 2023).
1. D. Elder, D. Massi, R. Scolyer, and R. Willemze, eds., WHO Classification of Skin Tumors, vol. 11, 4th ed. (International Agency for Research on Cancer, 2018).
1. L. E. Zimmerman and L. K. Garron, “Melanocytoma of the Optic Disc,” International Ophthalmology Clinics 2, no. 2 (1962): 431–440.

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Shifts in Cutaneous Melanocytic Tumor Diagnostic Terminology: Melanocytoma, MPATH-Dx V2.0 and the WHO Skin5

Affiliations

Shifts in Cutaneous Melanocytic Tumor Diagnostic Terminology: Melanocytoma, MPATH-Dx V2.0 and the WHO Skin5

Authors

Affiliations

Abstract

References

Publication types

Grants and funding

LinkOut - more resources

Full Text Sources