Tognetti L, Cinotti E, Perrot J L, Campoli M, Fimiani M, Rubegni P
Division of Dermatology - Department of Medical, Surgical and Neuro Sciences, University of Siena, Siena, Italy.
Department of Medical Biotechnologies, University of Siena, Siena, Italy.
Skin Res Technol. 2018 May;24(2):313-317. doi: 10.1111/srt.12432. Epub 2018 Jan 31.
Though the combination/collision of nevi or lentigo simplex and hemangiomas is frequent, the malignant collision tumor melanoma-hemangioma is exceptional and can sometime clinically simulate a benign collision. To date, a series of collision tumors of hemangiomas associated with either benign or malignant melanocytic skin lesions (MSL) has yet to be studied by non-invasive imaging and clinico-pathologic correlates.
We present 10 cases of patients with collision tumors of hemangioma with different MSL including: 2 in situ lentigo-maligna melanoma, 1 invasive melanoma, 5 melanocytic nevi, and 2 lentigo simplex. The clinical aspect along with the dermoscopic and reflectance confocal microscopy (RCM) features is described and compared with histopathologic findings.
Dermoscopic examination allows to recognize a dark ring in malignant collision melanoma-hemangioma and a jelly ring sign in benign collision of nevi/lentigo simplex-hemangioma. These peculiar features were confirmed by RCM and histopathologic findings.
Two simple dermoscopic clues confirmed by RCM features can be proposed to help distinguish between benign and malignant collisions tumors.
虽然痣或单纯性雀斑样痣与血管瘤的合并/碰撞很常见，但恶性碰撞肿瘤黑色素瘤 - 血管瘤则较为罕见，有时在临床上可模拟良性碰撞。迄今为止，一系列与良性或恶性黑素细胞性皮肤病变（MSL）相关的血管瘤碰撞肿瘤尚未通过无创成像及临床病理相关性进行研究。
我们报告了10例患有血管瘤与不同MSL碰撞肿瘤的患者，包括：2例原位恶性雀斑样痣黑色素瘤、1例浸润性黑色素瘤、5例黑素细胞痣和2例单纯性雀斑样痣。描述了临床情况以及皮肤镜和反射式共聚焦显微镜（RCM）特征，并与组织病理学结果进行比较。
皮肤镜检查可识别恶性碰撞黑色素瘤 - 血管瘤中的暗环以及痣/单纯性雀斑样痣 - 血管瘤良性碰撞中的果冻环征。这些特殊特征通过RCM和组织病理学结果得到证实。
可以提出两个经RCM特征证实的简单皮肤镜线索，以帮助区分良性和恶性碰撞肿瘤。
