title: Clinical and pathological features of metastases of primary cutaneous desmoplastic melanoma.
abstract: OBJECTIVE
  Primary cutaneous desmoplastic melanoma (DM) may be entirely desmoplastic ['pure' DM (pDM)] or exhibit a desmoplastic component admixed with a non-desmoplastic component ['combined' DM (cDM)]. Our aim was to describe the histological features of metastases of primary DM and to determine whether they were predictive of outcome.
  
  
  METHODS
  The effect of clinicopathological parameters on overall survival (OS) was analysed, and the correlation between histological features of the primary melanoma and metastases was studied in patients with metastatic DM.
  
  
  RESULTS
  Twenty-six patients (18 males; eight females) developed 50 metastases in sentinel nodes (13; 26.0%), regional nodes (10; 20.0%), skin (14; 28.0%), and distant sites (13; 26.0%). The cellular composition of metastases correlated with that of the corresponding primary tumours. Time to development of first non-sentinel lymph node metastasis was shorter in cDM than in pDM (median 11.2 versus 24.9 months, P = 0.075). The only independent predictors of poorer OS were cDM type [hazard ratio 6.17, 95% confidence interval (CI) 1.61-23.81, P = 0.008] and male sex (hazard ratio 5.98, 95% CI 1.34-26.66, P = 0.019).
  
  
  CONCLUSIONS
  The cellular composition of primary DM correlates with that of metastatic DM and with outcome. It is important to consider the possibility of primary or metastatic DM when examining tumours composed of spindle cells.
authors: Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, NSW, Australia. MuraliR@mskcc.org
authors: Rajmohan
authors: R
authors: Murali
authors: Diana
authors: D
authors: Zannino
authors: Maria
authors: M
authors: Synnott
authors: Stanley W
authors: SW
authors: McCarthy
authors: John F
authors: JF
authors: Thompson
authors: Richard A
authors: RA
authors: Scolyer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D049109:Cell Proliferation; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008545:Melanoma / Q000556:secondary*; D008875:Middle Aged; D009336:Necrosis / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D012867:Skin / Q000473:pathology*; D012878:Skin Neoplasms / Q000473:pathology*