TY - JOUR
T1 - Melanoma coexisting with solar elastosis
T2 - a potential pitfall in the differential diagnosis between nevus and melanoma
AU - Konopinski, Jonathan C.
AU - Danialan, Richard
AU - Torres-Cabala, Carlos A.
AU - Tetzlaff, Michael T.
AU - Nagarajan, Priyadharsini
AU - Curry, Jonathan L.
AU - Ivan, Doina
AU - Prieto, Victor G.
AU - Aung, Phyu P.
PY - 2019/2
Y1 - 2019/2
N2 - Melanomas, like nonmelanoma skin cancers, are known to be causally related to sun exposure. It is therefore not surprising to see benign nevi and melanomas in a background of solar damage, which at times may complicate their distinction. Because of their long-standing nature, nevi often occur before the development of solar elastosis and as such are intimately associated with the solar elastosis. In contrast, visible solar elastosis often occurs before the development of melanoma, in which case the band of solar elastosis is displaced downward from the overlying invasive melanoma and/or its host response. We describe 4 cases in which invasive melanoma cells were intimately admixed with actinically damaged elastin fibers in the absence of a prominent host response. In each case, melanoma cells were admixed with prominent solar elastosis and lacked a significant host response, suggesting that they were either histiocytes or an associated melanocytic nevus. Recognition of this potential pitfall may be helpful in the diagnosis of primary/in-transit/satellite/metastatic melanoma as well as when evaluating marginal status and determining Breslow thickness.
AB - Melanomas, like nonmelanoma skin cancers, are known to be causally related to sun exposure. It is therefore not surprising to see benign nevi and melanomas in a background of solar damage, which at times may complicate their distinction. Because of their long-standing nature, nevi often occur before the development of solar elastosis and as such are intimately associated with the solar elastosis. In contrast, visible solar elastosis often occurs before the development of melanoma, in which case the band of solar elastosis is displaced downward from the overlying invasive melanoma and/or its host response. We describe 4 cases in which invasive melanoma cells were intimately admixed with actinically damaged elastin fibers in the absence of a prominent host response. In each case, melanoma cells were admixed with prominent solar elastosis and lacked a significant host response, suggesting that they were either histiocytes or an associated melanocytic nevus. Recognition of this potential pitfall may be helpful in the diagnosis of primary/in-transit/satellite/metastatic melanoma as well as when evaluating marginal status and determining Breslow thickness.
KW - Margin status
KW - Melanoma
KW - Nevus
KW - Satellite/in-transit/metastatic melanoma
KW - Solar elastosis
UR - http://www.scopus.com/inward/record.url?scp=85060107311&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85060107311&partnerID=8YFLogxK
U2 - 10.1016/j.humpath.2018.10.010
DO - 10.1016/j.humpath.2018.10.010
M3 - Article
C2 - 30359637
AN - SCOPUS:85060107311
SN - 0046-8177
VL - 84
SP - 270
EP - 274
JO - Human Pathology
JF - Human Pathology
ER -