Clinical and Pathological Correlation of Malignant Melanoma

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Abstract
Forms of cutaneous and mucocutaneous melanomas were reviewed. Superficial spreading [SSM], lentigo maligna and nodular melanomas [NM] have been more thoroughly investigated and documented in previous studies. Lentigo maligna melanoma appears to have a longer duration and better prognosis than SSM or NM. The overall prognosis probably correlates better with the anatomic level and thickness of invasion than with type. It appears that certain pitfalls exist in either method of assessing prognosis, and it is recommended that both methods be applied in evaluating a malignant melanocytic lesion when feasible. Regarding in situ melanoma or Level I melanoma, such lesions can probably achieve a 100% cure rate when completely excised. Such lesions can probably achieve a 100% cure rate when completely excised. Such lesions are called severely atypical melanocytic hyperplasia, and these patients with a malignant diagnosis should not be labeled. The most difficult histologic challenge in diagnosing a lesion of malignant melanoma is the Spitz nevus. The pathologist should never be biased by the age of the patient, for a serious mistake can arise. A case of nodular melanoma in a 13 yr old girl diagnosed as Spitz nevus only to be followed by a lymph node metastasis years later was reported. Other examples of histologic differential diagnoses of malignant melanomas include, halo nevus, soft tissue sarcoma, squamous cell carcinoma with spindle cell proliferation and Paget''s disease of metastatic carcinoma, (for example, from the breast). The approach to the diagnosis of malignant melanoma necessitates an evaluation of clinical and pathological features. Histologic study must encompass the pattern of growth and cellular cytologic detail for successful interpretation.