Desmoplastic Melanoma: A Clinicopathological Analysis of Three Cases in the Chinese Population

Abstract

Purpose: To investigate the clinicopathological characteristics and immunophenotype of desmoplastic melanoma (DM) in the Chinese population. Patients and Methods: We report three cases of DM diagnosed by the Pathology Department of Shanghai Dermatology Hospital. We describe the clinical and pathological characteristics of the three cases and examine molecular markers used in the diagnosis of DM. Finally, we summarize the current literature in the DM field. Results: Clinically, lesions in the three DM patients were characterized by non-pigmented nodules or papules. Microscopically, we observed an abundance of fibrous interstitium mixed with spindle cells exhibiting various degrees of atypia. Occasionally, these structures exhibited changes in lentigo maligna at the epidermal junction, accompanied by the presence of lymphoid follicular structures and neurophilic behavior. Diagnosis of DM was confirmed by immunohistochemical staining, which revealed high expression levels of S-100 and SOX-10. Melanocyte markers were focally positive or negative. Unlike DMs from other populations, our three patients were negative for WT-1 and P53. All three cases received surgical resection, which is the preferred treatment for DM, and none of the patients experienced recurrence. Conclusion: DM in these Chinese patients was similar to that observed in other DM populations in terms of immunophenotype and clinical and histological features. A notable absence in p53 staining was observed in the three cases reported here, suggesting that p53 negativity should not exclude the diagnosis of DM in the Chinese population.

Local Recurrence Rates After Excision of Desmoplastic Melanoma: A Systematic Review and Meta-Analysis

“…13,37 These 53 studies were published from 1971 to 2021 and included 3,080 DM; they consisted of 2 single-arm prospective studies (evaluating WLE for DM 39 or WLE and adjuvant radiation for DM 40 ), 1 case control study (comparing DM with other melanoma subtypes), 41 and 50 case series (see Supplemental Digital Content , Table S2, http://links.lww.com/DSS/B209, for studies). 7,11,13–25,30,37,39–74 The studies had a high risk of bias per the ROBINS-I assessment.…”

“…Thirteen studies reported LRR associated with or without adjuvant radiation therapy. 13,19,20,25,40,43,45,48,53,55,56,64,68 11 studies included tumors treated with or without adjuvant radiation 13,19,20,25,40,45,48,55,56,64,68 and 2 studies exclusively included patients treated with adjuvant radiation. 43,53 Data from all 13 studies were analyzed to calculate and compare summary estimates of LRR by use of adjuvant radiation.…”

“…13,19,20,25,40,43,45,48,53,55,56,64,68 11 studies included tumors treated with or without adjuvant radiation 13,19,20,25,40,45,48,55,56,64,68 and 2 studies exclusively included patients treated with adjuvant radiation. 43,53 Data from all 13 studies were analyzed to calculate and compare summary estimates of LRR by use of adjuvant radiation. The LRR was 7% (95% CI, 0.05-0.11; I 2 5 0, p 5 1.00) for tumors treated with adjuvant radiation (n 5 287) versus 21% (95% CI, 0.13-0.34; I 2 5 85%, p , .01) for those treated without adjuvant radiation (n 5 572; p , .01 for subgroup differences; see Supplemental Digital Content, Figure S9, http://links.lww.com/DSS/B209).…”

“…39 Seventeen studies reported LRR associated with neurotropic status. 7,11,13,14,17,21,22,24,25,43,48,53,60,62,64,69,74 13 included neurotropic and non-neurotropic tumors 7,11,13,17,21,24,25,43,53,62,64,69,74 and 4 included exclusively neurotropic tumors. 14,22,48,60 We performed 2 analyses to examine LRR by neurotropic status.…”

Desmoplastic melanoma presenting as an alopecic patch in a young patient

“… 1 , 2 Initially described by Conlev et al, 3 as a superficial melanotic lesion with the histology of locally invasive fibrous tumors, DM has slowly increased in incidence. 4 Epidemiologically, risk remains highest in chronically sun-exposed individuals, with a male to female ratio of 2:1, and in older individuals, with a mean age of onset of 66 years. 1 …”