Focal invasiveness in complete histological analyses of a large acral lentiginous melanoma

Abstract

BackgroundAcral lentiginous melanoma is a melanoma with poor prognosis which is frequently diagnosed at an advanced stage. Since the thickness of tumour is one of the main prognostic factors, this case can exemplify how important complete histological analyses looking for focal invasiveness can be.Case reportA 77 year-old woman with a black spot with slow progressive growth on the left plantar region. She sought medical attention due to the expansion onto the dorsal surface of toes. The lesion had irregular borders and had spread to half the plantar surface. Histopathology confirmed the clinical suspicion of acral lentiginous melanoma Clark level IV and 2.6 mm Breslow thickness. The surgical specimen was entirely processed for histological evaluation, requiring 53 slides. Tumor dermal invasion was detected in only three out of 53 glass slides as the invasiveness was not identified by clinical, dermatoscopy or macroscopy exams.ConclusionSectioning through the entire lesion is considered very important to determinate the appropriate stage of the disease and the correct treatment and patient follow-up.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1513617994148349.

Acral melanoma of the foot: a study of 9 cases and guidelines update

“…Il reste le type le plus décrit chez les sujets à peau pigmentée; en Afrique [1] et en Asie [8][9][10][11][12][13]. Chez le caucasien, le mélanome acral est rare [3,6].…”

D‐tyrosine negatively regulates melanin synthesis by competitively inhibiting tyrosinase activity

“…For instance, although melanoma is more rare in Asian populations than in fair-skinned populations, certain subtypes of melanoma (e.g., mucosal melanoma and acral lentiginous melanoma) have high incidences in Asian countries (Chan, Chan, Ho, & Chan, 2016). Moreover, the prognosis of Asian patients with acral lentiginous melanoma is very poor (Xavier-Junior et al, 2015), and Asian patients with melanoma tend to present with thicker tumors and an advanced disease state (Bellew, Del Rosso, & Kim, 2009). Therefore, there is an urgent need for researchers to develop alternative ways to regulate melanogenesis.…”