A Retrospective Histological Study of 669 Cases of Primary Cutaneous Malignant Melanoma in Clinical Stage I

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Abstract
A selected series of 669 primary malignant melanomas of the skin, stage I, was studied. The series includes 86 lentigo maligna melanomas, 259 superficial spreading malignant melanomas, 194 nodular malignant melanomas and 130 unclassifiable malignant melanomas. The tumor cell type was classified and the tumor cell pigmentation, the cellular atypia and the mitotic count was graded. The relation of these 4 tumor cell features to each other and to the tumor type was studied by .CHI. [Chi square] tests. The prognostic value of these features in relation to the total series and to each tumor type was examined. The most common features were mixed cellularity, little pigment, moderate atypia and low mitotic count. Most of these tumors were superficial spreading malignant melanomas. A good prognosis was related to spindle-shaped tumor cells, marked pigmentation, slight atypia and few mitoses. A bad prognosis was related to epithelioid tumor cells, little pigment, marked atypia and many mitoses. Variations of lentigo maligna melanoma tended to be more malignant than the average. A superficial spreading malignant melanoma might vary in either direction.