The Pedunculated Malignant Melanoma: A Misunderstood and Neglected Variant

Abstract

A case of a truly pedunculated malignant melanoma is described. It is a rare form of malignant melanoma. Accurate description of it and statistics of its frequency are difficult to come by in the literature because of the prevailing confusion between this form and the "polypoid" type of malignant melanoma.

Pedunculated Malignant Melanoma

“…It is interesting to note that our patient's lesion, according to her history, started as a “flat mark” that looked atypical enough to warrant a recommendation of removal 2 years prior to its presentation as a pedunculated melanoma. A similar natural history of the disease was reported in a case by Rosenberg et al 7 This is in contrast to what is classically described in the literature on pedunculated melanomas, as it is believed that this variant lacks a horizontal growth phase, which is more typical of a superficial spreading melanoma. Furthermore, this lesion does not meet the Vogler definition of pedunculated melanoma in that the lateral spread of tumor goes beyond three rete ridges.…”

Pedunculated Malignant Melanoma

“…Malignant melanomas in the gross form of pedunculated lesions have been reported only four times in the English literature 1–4 to our knowledge.…”

Polypoid Spitz naevus: the benign counterpart of polypoid malignant melanoma

“…Initially, this form of melanoma was felt to carry a particularly poor prognosis, 1 , 6–8 but this is not generally held to be the case now as it is well established that the prognosis for polypoid melanoma is similar to other lesions of equivalent Breslow thickness. 9–12 From a clinical point of view polypoid melanoma frequently shows a very rapid growth rate and the lesion takes only few months (or weeks) to attain its huge dimensions.…”