title: Desmoplastic malignant melanoma associated with pigmented ocular tumor: second documented problematic case from the board of adcrstr-association for dermatohistopathologic control, re-evaluation and subsequent therapeutic recommendations.
abstract: Malignant melanoma is the most malignant skin tumor, whose incidence is rising gradually. It usually occurs in pre-existing lesions in photo-exposed areas of the skin, and, despite its occurrence across a broad age range, its appearance prevails among the elderly. It has a tendency to metastasize rapidly. Secondary lesions are often located on mucous membranes including the conjunctiva, which in turn leads to higher mortality. Despite significant achievements in tumor diagnostics, explicit verification of a possible malignant melanoma is achieved by surgical removal of the lesion and its subsequent detailed histopathology. The prognosis for patients is determined by the stage of the primary tumor, tumor thickness and the presence or absence of additional risk factors, respectively. We present the case of a 39-year old female patient who was diagnosed with malignant melanoma of the left shoulder with a tumor thickness of 1 mm. No further microscopic prognostic criteria were described in the histological report. The lack of additional histopathological criteria in the pathologists report, such as mitotic activity and angio-lymphatic invasion from a lesion with this sort of tumor thickness, is followed almost always by risky or inadequate diagnostic and therapeutic decisions that may have fatal consequences for patients. The newly created Association for Dermatohistopathologic Control, Reevaluation and Subsequent Therapeutic Reccomendation in Sofia, Bulgaria aims to focus attention on these errors, in order to promote a unified histopathologic assessment of skin tumors in accordance with generally accepted European and World standards. This should ultimately help the clinician by increasing the efficiency of subsequent diagnostic and therapeutic decisions.
authors.affiliation: Onkoderma-Policlinic for Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria.
authors.forename: E
authors.initials: E
authors.lastname: Trayanova
authors.affiliation: Onkoderma-Policlinic for Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria.
authors.forename: A A
authors.initials: AA
authors.lastname: Chokoeva
authors.affiliation: University of Virginia Health System, Department of Pathology and Dermatology, Charlottesville, VA USA.
authors.forename: J W
authors.initials: JW
authors.lastname: Patterson
authors.affiliation: Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Wollina
authors.affiliation: Professor and Chair of Dermatology, University of Rome "G. Marconi", Rome, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Lotti
authors.affiliation: Onkoderma-Policlinic for Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria.
authors.forename: G
authors.initials: G
authors.lastname: Tchernev