Cauliflower-like exophytic mass on the skin: polypoid melanoma. Clinical, dermoscopic, and histologic features

Abstract

Polypoid melanoma is a variant of nodular melanoma, whose poor prognosis depends on its thickness and the presence of ulceration at the time of diagnosis. The authors report two cases of polypoid melanoma, presenting as broad, cauliflower-like, polypoid masses. Dermoscopy was characterized by a multicolored pattern, atypical polymorphic vessels, and the fiber sign. Clinical and dermoscopic features can help to diagnose polypoid melanoma and exclude other possible differential diagnoses. However, histology remains mandatory to confirm the diagnostic suspicion.

Characteristics of Giant Nodular Melanomas in Special Locations: a Case Series and Review of the Literature

“…Moreover, the “fiber sign” was described, defined as the presence of gauze filaments trapped into the irregular surface of the tumor, similarly to our observations in acral giant nodular melanoma (Fig. 1 f, h, j, l) [ 2 ].…”

“…In the case study of Altobrando et al. concerning two giant melanomas, dermoscopy showed a multicolored pattern with a diffuse yellow background and some irregularly distributed red, brown, and gray areas [ 2 ]. In the literature, in giant nodular melanomas, the vessels appeared atypical, polymorphic, and mainly dilated over a red and white background [ 2 ].…”

“…concerning two giant melanomas, dermoscopy showed a multicolored pattern with a diffuse yellow background and some irregularly distributed red, brown, and gray areas [ 2 ]. In the literature, in giant nodular melanomas, the vessels appeared atypical, polymorphic, and mainly dilated over a red and white background [ 2 ]. In two of our cases of giant melanoma, we found the following features: the presence of polymorphous vessels in addition to serpentine vessels (3/6) (Fig.…”

“…In the literature, only a few papers reported on the dermoscopic features of NM [ 1 – 5 ]. To our knowledge, probably only one dermoscopic report on primary giant nodular melanoma has been published so far, but it did not address specific locations [ 2 ].…”

Polypoid Melanoma: Towards a Dermoscopic Approach

“…This rare and aggressive variant of nodular melanoma can be dermoscopically distinguished from clinically similar tumors by the recognition of irregular crusted-fibrinous surfaces, atypical polymorphic vessels, blue-white veils in the exophytic portion, a multicolored pattern, and blue-gray nests at the base [1,2].…”