Naslov
Invazivni melanom malog promjera: kliničke, dermoskopske i histopatološke karakteristike
(Small diameter invasive melanomas: clinical, dermoscopic and histopathological findings)

Autori
Garces Rene, Joan ; Đurinec, Paola ; Bradamante, Mirna ; Radoš, Jaka ; Bukvić Mokos, Zrinka ; Ledić Drvar, Daniela

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Skup
7. kongres hrvatskih dermatovenerologa s međunarodnim sudjelovanjem

Mjesto i datum
Vodice, Hrvatska, 05.05.2022. - 08.05.2022

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
small diameter invasive melanomas, dermoscopy, histopathology

Sažetak
INTRODUCTION Traditionally, small-pigmented lesions that didn’t fit the ‘ABCD’ criteria (< ; 6 mm) were overlooked. Nowadays, small melanomas have a reported frequency of 11.4-38.2% of all melanomas. Small melanomas can already be invasive with Breslow thickness over 2 mm, and rarely show the common dermoscopic features of larger melanomas. OBJECTIVE, MATERIALS AND METHODS We are presenting two patients who presented for a routine mole check-up. During examination we found in both of them lesions that were clinically symmetrical and inconspicuous, but dermoscopy identified suspicious lesions. Both lesions were subject to excisional biopsy. RESULTS First case: During the examination of a 68 years old male we found a suspicious dark pigmented lesion on the lower back with a 3mm diameter. Dermoscopy showed irregular hyperpigmented area in a brown structureless area and atypical dotts. Histopathology showed larger melanocytes in the basal layer of epidermis. In the underlying papillary dermis melan A + atypical melanocytes were seen. Melanocytes were located within a dense infiltrate consisting of lymphocytes and pigmentophages. The diagnosis of invasive melanoma was rendered (pT1a, Breslow 0.3 mm). Second case: A suspicious, 3 mm in size, pigmented lesion on the back of a 73 years old female was noticed. Dermoscopy showed a prevalent globular patter with large globules varying in shape, color and size, and a thickened and branched pigmented network at the periphery ; it also presented unevenly distributed dots and an irregular dark blotch. Histopathology showed junctional and dermal nests of atypical, pleomorphic melanocytes.The diagnose of a “nested nevoid melanoma” was established (pT1a, Breslow 0.5 mm). CONCLUSION Clinically, small diameter melanomas have greater frequency and intensity of black coloration. Dermoscopy can be challenging as they usually lack many of the features that larger ones have. They rarely present more than two colours, blue-white veil or regression. Instead we should be looking for irregular hyperpigmented areas, atypical network with atypical dots/globules in a structureless pattern. When performing mole examination, small clinically innocent lesions should not be overlooked, since they can already be invasive melanomas, as our cases showed.

Izvorni jezik
Engleski

POVEZANOST RADA