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An atypical melanocytic lesion without genomic abnormalities shows locoregional metastasis.
J Cutan Pathol 2012; 39(1):21-4JC

Abstract

A subset of difficult melanocytic lesions exists with histopathologic features that evade diagnostic consensus from even expert dermatopathologists. Comparative genomic hybridization (CGH) has emerged as a useful diagnostic tool to categorize these lesions, by identifying known chromosomal aberrations in malignant melanoma or the lack thereof in melanocytic nevi. However, determining a lesion's biological behavior primarily on CGH is limited by a relatively small series of corroborative cases without long term follow up. We present a case of a pigmented lesion on the right cheek of a 4 year old boy. The lesion had features of a deep penetrating nevus, but the presence of frequent mitoses, tumor infiltrating lymphocytes, and microscopic foci of tumor necrosis were concerning for an unusual melanoma. We termed this lesion a melanocytic tumor of uncertain potential (MELTUMP) for these reasons. High-resolution array-CGH performed elsewhere on the lesion demonstrated no melanoma-associated genomic abnormalities. A sentinel lymph node biopsy of this patient later revealed multiple small tumor deposits. Although the presence of nodal involvement in similar lesions often do not lead to progressive and fatal disease, this case illustrates that atypical melanocytic lesions with nodal involvement may not demonstrate genomic abnormalities by CGH, and that histopathologic assessment remains paramount in defining these difficult melanocytic lesions. Further comprehensive study of these lesions is needed.

Authors+Show Affiliations

Department of Pathology, University of Pennsylvania, Philadelphia, PA, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

22211332

Citation

Abraham, Ronnie M., et al. "An Atypical Melanocytic Lesion Without Genomic Abnormalities Shows Locoregional Metastasis." Journal of Cutaneous Pathology, vol. 39, no. 1, 2012, pp. 21-4.
Abraham RM, Ming ME, Elder DE, et al. An atypical melanocytic lesion without genomic abnormalities shows locoregional metastasis. J Cutan Pathol. 2012;39(1):21-4.
Abraham, R. M., Ming, M. E., Elder, D. E., & Xu, X. (2012). An atypical melanocytic lesion without genomic abnormalities shows locoregional metastasis. Journal of Cutaneous Pathology, 39(1), pp. 21-4. doi:10.1111/j.1600-0560.2011.01849.x.
Abraham RM, et al. An Atypical Melanocytic Lesion Without Genomic Abnormalities Shows Locoregional Metastasis. J Cutan Pathol. 2012;39(1):21-4. PubMed PMID: 22211332.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An atypical melanocytic lesion without genomic abnormalities shows locoregional metastasis. AU - Abraham,Ronnie M, AU - Ming,Michael E, AU - Elder,David E, AU - Xu,Xiaowei, PY - 2012/1/4/entrez PY - 2012/1/4/pubmed PY - 2012/5/2/medline SP - 21 EP - 4 JF - Journal of cutaneous pathology JO - J. Cutan. Pathol. VL - 39 IS - 1 N2 - A subset of difficult melanocytic lesions exists with histopathologic features that evade diagnostic consensus from even expert dermatopathologists. Comparative genomic hybridization (CGH) has emerged as a useful diagnostic tool to categorize these lesions, by identifying known chromosomal aberrations in malignant melanoma or the lack thereof in melanocytic nevi. However, determining a lesion's biological behavior primarily on CGH is limited by a relatively small series of corroborative cases without long term follow up. We present a case of a pigmented lesion on the right cheek of a 4 year old boy. The lesion had features of a deep penetrating nevus, but the presence of frequent mitoses, tumor infiltrating lymphocytes, and microscopic foci of tumor necrosis were concerning for an unusual melanoma. We termed this lesion a melanocytic tumor of uncertain potential (MELTUMP) for these reasons. High-resolution array-CGH performed elsewhere on the lesion demonstrated no melanoma-associated genomic abnormalities. A sentinel lymph node biopsy of this patient later revealed multiple small tumor deposits. Although the presence of nodal involvement in similar lesions often do not lead to progressive and fatal disease, this case illustrates that atypical melanocytic lesions with nodal involvement may not demonstrate genomic abnormalities by CGH, and that histopathologic assessment remains paramount in defining these difficult melanocytic lesions. Further comprehensive study of these lesions is needed. SN - 1600-0560 UR - https://www.unboundmedicine.com/medline/citation/22211332/An_atypical_melanocytic_lesion_without_genomic_abnormalities_shows_locoregional_metastasis_ L2 - https://doi.org/10.1111/j.1600-0560.2011.01849.x DB - PRIME DP - Unbound Medicine ER -