title: Desmoplastic melanoma.
abstract: Desmoplastic melanoma is an uncommonly encountered variant of malignant melanoma. Three histological subtypes exist: desmoplastic, neurotropic, and neural transforming. Desmoplastic melanoma commonly presents in conjunction with existing melanocytic lesions or as an amelanotic firm nodule. Local recurrences are common. Thirty patients over a 6-year period were treated at our institution for desmoplastic melanoma. All lesions were treated with local excision. Local recurrence occurred in seven patients (23%) and was treated by aggressive re-excision in each instance. Clinical regional metastasis (lymph nodal basins) were detected in two patients (6%). Distant metastasis (lung) developed in two patients (6%). Twenty-three patients (76%) were found to have desmoplastic subtype, whereas five (17%) had neurotropic subtype. Six patients (20%) had associated pigmented melanotic lesions. Average length of follow-up has been 18 months. Overall survival is 96 per cent. Presentations and histologic diagnosis can sometimes be difficult and misleading. Treatment is aggressive local excision with follow-up necessary to detect resectable recurrent lesions.
authors.affiliation: Department of Surgery, University of South Florida, Tampa, USA.
authors.forename: W G
authors.initials: WG
authors.lastname: Payne
authors.forename: R
authors.initials: R
authors.lastname: Kearney
authors.forename: K
authors.initials: K
authors.lastname: Wells
authors.forename: M
authors.initials: M
authors.lastname: Blue
authors.forename: M
authors.initials: M
authors.lastname: Walusimbi
authors.forename: G
authors.initials: G
authors.lastname: Mosiello
authors.forename: C W
authors.initials: CW
authors.lastname: Cruse
authors.forename: D
authors.initials: D
authors.lastname: Reintgen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000601:surgery*; D008875:Middle Aged; D012878:Skin Neoplasms / Q000601:surgery*