title: Ex vivo dermoscopy for biobank-oriented sampling of melanoma.
abstract: OBJECTIVE
  In the era of targeted therapy for cancer, translational research identifying molecular targets in melanoma offers novel opportunities for potential new treatments.
  
  
  OBJECTIVE
  To describe a method for sampling fresh tissue from primary melanoma and to test whether the area of maximal thickness can be identified with dermoscopy to ensure it remains available for routine histopathological diagnosis.
  
  
  METHODS
  Tumors clinically suspicious for melanoma with diameter exceeding 5 mm were included. Dermoscopy-guided sampling was performed using a 2-mm to 3-mm punch through not the thickest part of the tumor. In vivo and ex vivo dermoscopic images obtained were available to the diagnosing pathologist. Melanoma samples were obtained in a referral melanoma unit.
  
  
  METHODS
  In study 1, Breslow thickness in 10 melanomas was compared between sampled tissue and the remaining specimen to confirm that the area of maximal thickness remained available for the histopathological diagnosis. In study 2, forty-three additional melanomas were sampled for biobanking prospectively. Agreement between 2 independent observers on dermoscopic identification of the thickest part of the melanoma was studied.
  
  
  RESULTS
  In study 1, the area of maximal Breslow thickness in all 10 melanomas was not sampled and remained in the main specimen. In study 2, sampling was performed by one of the investigators. Concordance was 93% between 2 independent observers for the dermoscopic selection of the thickest portion of the melanoma. Pathologists asserted that the sampling procedure did not compromise their ability to evaluate melanoma specimens. A limitation is that this is a single-center study. Each case required joint evaluation by expert dermoscopists and dermatopathologists.
  
  
  CONCLUSIONS
  In applying the dermoscopy-guided sampling protocol, we make the following 5 recommendations: Samples should only be obtained from areas that will not interfere with the pathologist's diagnosis and prognostic information. Sampling should not be obtained from tumors for which one suspects that the histopathological evaluation may prove difficult. Sampling should not be performed on small melanomas; we recommend a minimum diameter of 10 mm. All the dermoscopy-guided sampling should be documented with images, available to pathologists and clinicians, and reflected in the pathology report. Finally, the frozen biobank samples should be made available for routine hematoxylin-eosin histopathological evaluation until the final pathology report is produced. Ex vivo dermoscopy may serve to guide the procurement of small samples from primary melanoma for fresh tissue biobanking without compromising the histopathological evaluation.
authors.affiliation: Melanoma Unit, Department of Dermatology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain2Centro de Investigacion Biomedica en Red Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain.
authors.forename: Joseph
authors.initials: J
authors.lastname: Malvehy
authors.forename: Paula
authors.initials: P
authors.lastname: Aguilera
authors.forename: Cristina
authors.initials: C
authors.lastname: Carrera
authors.forename: Gabriel
authors.initials: G
authors.lastname: Salerni
authors.forename: Louise
authors.initials: L
authors.lastname: Lovatto
authors.forename: Alon
authors.initials: A
authors.lastname: Scope
authors.forename: Ashfaq A
authors.initials: AA
authors.lastname: Marghoob
authors.forename: Josep
authors.initials: J
authors.lastname: Palou
authors.forename: Llúcia
authors.initials: L
authors.lastname: Alós
authors.forename: Susana
authors.initials: S
authors.lastname: Puig
mesh_terms: D018070:Biological Specimen Banks; D046169:Dermoscopy / Q000379:methods*; D004801:Eosine Yellowish-(YS); D005456:Fluorescent Dyes; D006416:Hematoxylin; D006801:Humans; D008545:Melanoma / Q000175:diagnosis* / Q000473:pathology; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology; D013048:Specimen Handling / Q000379:methods
chemical_list: D005456:Fluorescent Dyes; D004801:Eosine Yellowish-(YS); D006416:Hematoxylin