Acral Lentiginous Melanoma

Abstract

Acral lentiginous melanoma (ALM) is the fourth clinicopathologic variant of malignant melanoma. It occurs on volar surfaces of hands and feet, subungual sites, and fingers or toes. It is characterized by slow lentiginous radial growth and central plaque-like thickening, heavily pigmented tumor cells, markedly thickened papillary dermis, and diffuse reticular infiltration. Lesions are unusually large and, in most cases, thick and ulcerated. There were 180 patients with acral melanoma (AM), which includes 67 in whom the specific features of ALM could be documented. One hundren sixty had primary lesions on ;the foot, and 20 occurred on the hand. There were 104 men and 76 women. There were 41 black patients and 139 whites. Five-year survivals following all modalities of therapy in 122 patients with Stage I acral melanoma is 63% for planter/palmar lesions, 58% for subungual lesions, and 27% for skin of digits. For the subgroup of Stage I patients with ALM treated by surgery and regional chemotherapy by perfusion, the five-year survival for all sites is 72% and 56% at 10 and 15 years, respectively. Survival in ALM is essentially the same as for all AM lesions.

Thickness of Malignant Melanoma: Global Analysis of Related Factors

“…The classification of MM into types has been the topic of much debate in the recent literature (Lieblich, 1982, Rampen, 1983). Proponents of the concept claim that certain subsets of MM have distinct clinical, cellular and behavioral characteristics as well as different cumulative survival rates (Bigotti et al, 1981; Clark et al, 1986; Holman and Armstrong, 1984a; Jimbow et al, 1984; Krementz et al, 1982; Larsen and Grude, 1978a‐c; McGovern and Murad, 1985; Milton et al, 1985a; Roberts et al, 1981; Shiftman et al, 1980; Sondergaard, 1983).…”

“…* * Blois et al, 1983b; Clark 1967; Clark et al, 1975, 1986; Donnellan et al, 1972; Elder et al, 1982; Goldman, 1980; Harwood, 1983; Heenan and Holman, 1982; Jeffrey et al, 1983; Jimbow et al, 1984; Johnson et al, 1985; Koh et al, 1984b; Krementz et al, 1982; Paladugu et al, 1983; Papachristou and Fortner, 1982; Roberts et al, 1981; Seiji et al, 1979; Sober et al, 1980; Sondergaard, 1983; Takematsu et al, 1985; Vazquez et al, 1984; Wade and White, 1986. …”

p16INK4a inactivation is not frequent in uncultured sporadic primary cutaneous melanoma

“…Another more interesting possibility is that the dierent type of melanoma examined in both studies might be responsible for the dierent frequency of LOH of 9p21-22. More than half of our samples were acral melanomas which are the main type of melanoma in Japanese and dier from other types of melanomas in clinical characteristics (Krementz et al, 1982;Seiji et al, 1979) and in antigenic pro®le (Kageshita et al, 1991). Although we did not ®nd signi®cant dierence in frequency of LOH between acral and non-acral melanomas in our limited number of cases, the unexpectedly low frequency of allelic loss on chromosome arm 9p in acral melanomas (5/28; 18%) raises the possibility that the genetic pathways to this particular type of melanoma might be dierent from those to non-acral melanomas commonly seen in Caucasians.…”

Subungual melanoma: A 25‐year review of cases

“…The influence of lymph node involvement could not be Rushforth reported an incidence of 2.55 per l~, m ascertained since regional node dissection was performed 2-3% of patients with malignant melanoma in several The purpose of this study was to evaluate subungual large series [4-71, B~~~~~~ of its rarity subungual mela-melanoma as a site-specific entity, to determine the influnoma has been commonly described in reports as ence of regional nodal involvement and to ascertain where part of larger series describing extremity melanomas or possible the role of histologic grading of the primary site. as clinicopathologic variants of malignant melanoma such as acral lentiginous melanoma [4][5][6][7][8]. Recent advances in the management of melanoma have been made through From l950 to lg759 33 patients with subungual melahowledge of determinants such as primary depth of noma underwent treatment at Memorial Sloan-Kettering invasion, thickness, presence of ulceration, stabs of re-Cancer Center.…”