Amelanotic melanoma of the head and neck: analysis of tumor characteristics from the National Cancer Database

Abstract

Background Amelanotic melanoma is an extremely rare subtype of cutaneous melanoma. The tumor characteristics are still not well understood, especially for those located in the head and neck. Methods Tumor characteristics of patients diagnosed with amelanotic melanoma of the head and neck (AMHN) from January 1, 2004, to December 31, 2015, were analyzed by querying the National Cancer Database. Characteristics of AMHN were subsequently compared with common malignant melanoma of the head and neck (CMMHN). Results Three hundred and sixty‐eight patients were diagnosed with AMHN, and 69,267 were diagnosed with CMMHN. Of those with AMHN, 128 (34.8%) had melanoma located on the scalp and neck, and 172 (46.7%) were diagnosed with an early disease stage (i.e., 0, I, or II). When compared with CMMHN, patients with AMHN were more likely to be diagnosed after 80 years of age (25.3% vs. 18.2%; odds ratio [OR], 3.28; 95% CI, 1.09–9.84; P = 0.03), when Breslow depth was between 2.01 and 4.00 mm (28.5% vs. 6.5%; OR, 1.92; 95% CI, 1.15–3.19; P = 0.01), when ulceration was present (36.7% vs. 9.0%; OR, 1.99; 95% CI, 1.34–2.97; P = 0.001), and when mitotic count was 1 or more/mm2 (40.5% vs. 12.8%; OR; 2.53; 95% CI, 1.09–5.89; P = 0.03). No statistical difference was found for sex, specific location, stage, or lymph node involvement. Conclusion Our study determined that AMHN is associated with older age, increased Breslow depth, presence of ulceration, and greater mitotic count when compared with CMMHN.

Melanoma metastasis: What role does melanin play? (Review)

“…Evaluation of tumour characteristics revealed that patients with AMHN had an increased Breslow depth and greater mitotic count when compared to CMHN (56). Breslow depth measures how deeply melanomas have spread to the skin while mitotic count is associated with the rate of metastasis (56). Another cross-sectional study performed on patients with scalp melanoma also revealed that invasive scalp melanoma was associated with amelanosis (57).…”

“…Progression of melanoma in these organs was also found to worsen with low pigmentation. In a recent retrospective study performed by Huayllani et al on 525,271 patients who were diagnosed with melanoma, 378 patients were diagnosed with amelanotic melanoma of the head and neck (AMHN) and 69,267 with common malignant melanoma of the head and neck (CMHN) (56). Evaluation of tumour characteristics revealed that patients with AMHN had an increased Breslow depth and greater mitotic count when compared to CMHN (56).…”

“…In a recent retrospective study performed by Huayllani et al on 525,271 patients who were diagnosed with melanoma, 378 patients were diagnosed with amelanotic melanoma of the head and neck (AMHN) and 69,267 with common malignant melanoma of the head and neck (CMHN) (56). Evaluation of tumour characteristics revealed that patients with AMHN had an increased Breslow depth and greater mitotic count when compared to CMHN (56). Breslow depth measures how deeply melanomas have spread to the skin while mitotic count is associated with the rate of metastasis (56).…”

Demographic Characteristics Influence Treatment Costs of Invasive Melanoma in Florida

“…However, specific demographic characteristics influence surgical management decisions, risk of hospitalization after excision, treatment contraindication, and patient outcome with this cancer 3–10 . Furthermore, demographic characteristics are known to be associated with other rarer types of melanoma and might also be associated with survival rates 11–16 …”