Acta Medica Iranica 2017. 55(5):316-323.

Patients' Characteristics, Histopathological Findings, and Tumor Stage in Different Types of Malignant Melanoma: A Retrospective Multicenter Study
Ali-Mohammad Farahmand, Amir-Hoshang Ehsani, Mojtaba Mirzaei, Maryam Mohsenian, Alireza Ghanadan


Cutaneous malignant melanoma (CMM) is currently the most fatal of skin cancers accounting for 50000 deaths annually. Five distinct melanomas are described histopathologically: superficial spreading, lentigo maligna, nodular, acral lentiginous and mucosal melanoma. The aim of this study was to investigate the characteristics of patients with various types of malignant melanoma and evaluate histopathological findings. In this retrospective study, we obtained our data from the records of 111 patients with melanoma. Biopsied specimens were collected and re-evaluated. Demographic information and histopathological findings were noted. SPSS 16 was used for analyzing data. Chi-square and one-way ANOVA was conducted for comparing categorical and numerical variables respectively. The mean age of patients was 59.33±14.68 years old. Most common melanoma type was acral lentiginous (40.5%), followed by nodular (35.1%) and mucosal (10.8%). The highest tumor thickness was viewed in nodular melanoma followed by mucosal melanoma. The highest rate of metastasis, microsatellitosis, perineural invasion and Clark level of the invasion were reported in nodular and acral lentiginous respectively. The most frequent rate of ulceration and vascular invasion was reported in mucosal melanoma. Distribution of melanoma types varies largely in different regions. Lack of classic presentations in some types necessitate specific public education about warning signs. Histopathological and pathological characteristics in melanoma can aid in better staging and management of the tumor.


Melanoma; Mitotic rate; Vascular invasion; Microsatellitosis; Tumor stage

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Geller AC, Clapp RW, Sober AJ, Gonsalves L, Mueller L, Christiansen CL, et al. Melanoma epidemic: an analysis of six decades of data from the Connecticut Tumor Registry. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2013;31(33):4172-8.

Azoury SC, Lange JR. Epidemiology, risk factors, prevention, and early detection of melanoma. The Surgical clinics of North America. 2014;94(5):945-62, vii.

Diffey BL. The future incidence of cutaneous melanoma within the UK. The British journal of dermatology. 2004;151(4):868-72.

American Cancer Society. Cancer facts and figures. 2014.

Albert VA, Koh HK, Geller AC, Miller DR, Prout MN, Lew RA. Years of potential life lost: another indicator of the impact of cutaneous malignant melanoma on society. Journal of the American Academy of Dermatology. 1990;23(2 Pt 1):308-10.

Phan A, Touzet S, Dalle S, Ronger-Savle S, Balme B, Thomas L. Acral lentiginous melanoma: a clinicoprognostic study of 126 cases. The British journal of dermatology. 2006;155(3):561-9.

Liu V, Mihm MC. Pathology of malignant melanoma. The Surgical clinics of North America. 2003;83(1):31-60, v.

J.A.A. Hunter. J.A. Savin. M.V. Dahl. Clinical Dermatology. 3rd edition: Blackwell publishing; 2002.

James WD, Berger T, Elston D. Andrew's diseases of the skin: clinical dermatology: Elsevier Health Sciences; 2011.

Mihajlovic M, Vlajkovic S, Jovanovic P, Stefanovic V. Primary mucosal melanomas: a comprehensive review. International Journal of Clinical and Experimental Pathology. 2012;5(8):739-53.

Marghoob AA, Koenig K, Bittencourt FV, Kopf AW, Bart RS. Breslow thickness and clark level in melanoma: support for including level in pathology reports and in American Joint Committee on Cancer Staging. Cancer. 2000;88(3):589-95.

Balch CM, Soong SJ, Atkins MB, Buzaid AC, Cascinelli N, Coit DG, et al. An evidence-based staging system for cutaneous melanoma. CA: a cancer journal for clinicians. 2004;54(3):131-49; quiz 82-4.

Balch CM, Buzaid AC, Soong SJ, Atkins MB, Cascinelli N, Coit DG, et al. Final version of the American Joint Committee on Cancer staging system for cutaneous melanoma. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2001;19(16):3635-48.

Bradford PT, Goldstein AM, McMaster ML, Tucker MA. Acral lentiginous melanoma: incidence and survival patterns in the United States, 1986-2005. Archives of dermatology. 2009;145(4):427-34.

Wu XC, Eide MJ, King J, Saraiya M, Huang Y, Wiggins C, et al. Racial and ethnic variations in incidence and survival of cutaneous melanoma in the United States, 1999-2006. Journal of the American Academy of Dermatology. 2011;65(5 Suppl 1):S26-37.

Reed KB, Brewer JD, Lohse CM, Bringe KE, Pruitt CN, Gibson LE. Increasing incidence of melanoma among young adults: an epidemiological study in Olmsted County, Minnesota. Mayo Clinic proceedings. 2012;87(4):328-34.

Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA: a cancer journal for clinicians. 2014;64(1):9-29.

McLaughlin CC, Wu XC, Jemal A, Martin HJ, Roche LM, Chen VW. Incidence of noncutaneous melanomas in the US. Cancer. 2005;103(5):1000-7.

Stalkup JR, Orengo IF, Katta R. Controversies in acral lentiginous melanoma. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al]. 2002;28(11):1051-9; discussion 9.

Chang AE, Karnell LH, Menck HR. The National Cancer Data Base report on cutaneous and noncutaneous melanoma: a summary of 84,836 cases from the past decade. The American College of Surgeons Commission on Cancer and the American Cancer Society. Cancer. 1998;83(8):1664-78.

Thompson JF, Scolyer RA, Kefford RF. Cutaneous melanoma. Lancet. 2005;365(9460):687-701.

Baade PD, English DR, Youl PH, McPherson M, Elwood JM, Aitken JF. The relationship between melanoma thickness and time to diagnosis in a large population-based study. Archives of dermatology. 2006;142(11):1422-7.

Chamberlain AJ, Fritschi L, Kelly JW. Nodular melanoma: patients' perceptions of presenting features and implications for earlier detection. Journal of the American Academy of Dermatology. 2003;48(5):694-701.

Kelly JW, Chamberlain AJ, Staples MP, McAvoy B. Nodular melanoma. No longer as simple as ABC. Australian family physician. 2003;32(9):706-9.

Liu Y, Sheikh MS. Melanoma: Molecular Pathogenesis and Therapeutic Management. Molecular and cellular pharmacology. 2014;6(3):228.

Kabigting FD, Nelson FP, Kauffman CL, Popoveniuc G, Dasanu CA, Alexandrescu DT. Malignant melanoma in African-Americans. Dermatology online journal. 2009;15(2):3.

Kimsey TF, Cohen T, Patel A, Busam KJ, Brady MS. Microscopic satellitosis in patients with primary cutaneous melanoma: implications for nodal basin staging. Annals of surgical oncology. 2009;16(5):1176-83.

Bartlett EK, Gupta M, Datta J, Gimotty PA, Guerry D, Xu X, et al. Prognosis of patients with melanoma and microsatellitosis undergoing sentinel lymph node biopsy. Annals of surgical oncology. 2014;21(3):1016-23.

Hale CS, Qian M, Ma MW, Scanlon P, Berman RS, Shapiro RL, et al. Mitotic rate in melanoma: prognostic value of immunostaining and computer-assisted image analysis. The American journal of surgical pathology. 2013;37(6):882-9.

Geller AC, Elwood M, Swetter SM, Brooks DR, Aitken J, Youl PH, et al. Factors related to the presentation of thin and thick nodular melanoma from a population-based cancer registry in Queensland Australia. Cancer. 2009;115(6):1318-27.

Callender GG, McMasters KM. What does ulceration of a melanoma mean for prognosis? Advances in surgery. 2011;45:225-36.

Bonnelykke-Behrndtz ML, Schmidt H, Christensen IJ, Damsgaard TE, Moller HJ, Bastholt L, et al. Prognostic stratification of ulcerated melanoma: not only the extent matters. American journal of clinical pathology. 2014;142(6):845-56.


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