The Classification of Cutaneous Melanoma
Section snippets
Existing classification schemes for melanoma
The existing classification schemes for melanoma include the histologic scheme adopted by the WHO9 and the AJCC staging scheme,8 both based on clinical and histologic parameters and both used routinely in the diagnosis and treatment of patients diagnosed with cutaneous melanoma.10 There have also been a handful of proposed genomic classifications, some of which have promise.10 One of these genomic surveys yielded results that validated the original classification of melanoma into subtypes and
Proposals for molecular schemes
After several decades of laboratory-based research, we now have a better understanding of some of the key pathways and potential therapeutic targets in melanoma tumor progression. Although translation of these findings from the research laboratory to clinical practice is in progress, none of these findings has led to a significant change in patient outcome or the development of a robustly effective therapy for any subset of patients with metastatic melanoma. In the future, molecular techniques
Morphologic and genomic classifications come together
An analysis of BRAF and NRAS mutations in coordination with histologic features revealed an aligning of certain histologic findings with BRAF mutation but not with NRAS. The primary tumors that displayed BRAF mutation had a higher frequency of intraepidermal single cell scatter, intraepidermal nesting, increased epidermal thickness, cytologic features that included epithelioid cells and cytoplasmic pigmentation, and a sharp circumscription of the tumor. These features are common to SSMs. This
Summary
Forty years ago a classification scheme and prognostic factors for cutaneous melanoma were described, based on detailed clinical features and histologic analysis, by an international group of authors. In addition to the subtypes—superficial spreading, nodular, lentigo maligna—prognostic factors including tumor thickness, ulceration, and mitotic activity were identified. There have been some tweaks to the classification scheme, but these basic findings form the foundation for the currently
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Cited by (59)
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2020, BiochimieCitation Excerpt :The incidence increased dramatically over the past 30 years [1], being the most common cancer in young adults aged 25–29 years and the second most common cancer in those aged 15–29 years [2]. Though the majority of the patients are treated by surgical excision of the primary tumor, still many patients develop metastases [3]. The exact cause of what damages DNA in skin cells and how this leads to melanoma is not clear, but it is believed to be a process that requires a complex interaction between exogenous and endogenous triggers as well as tumor-intrinsic and immune-related factors [4].
Pathology of Melanoma
2020, Surgical Clinics of North AmericaSurvival Benefit of Stereotactic Radiotherapy in the Complex Management of Metastatic Melanoma
2024, Anticancer Research