Marques Priscila Castelan, Diniz Lucia Martins, Spelta Karla, Nogueira Paulo Sergio Emerich
Dermatology Service, Hospital Universitário Cassiano Antonio Moraes, Universidade Federal do Espírito Santo, Vitória (ES), Brazil.
An Bras Dermatol. 2019 Jan-Feb;94(1):82-85. doi: 10.1590/abd1806-4841.20197481.
Desmoplastic melanoma, a distinct and uncommon variant, is characterized as an invasive lesion with proliferation of fusiform melanocytes in the dermis and subcutaneous tissue, associated with varying patterns of desmoplasia. Neurotropism and neural differentiation may occur. The clinical presentation is variable and nonspecific, easily confused with other fibrous neoplasms. The disease is locally aggressive and shows lower metastasis rates than other types of melanoma. Histopathology may be insufficient, requiring positive immunohistochemistry for S-100 protein and other antigens of melanocytic differentiation. Because desmoplastic melanoma represents a true clinical, dermoscopic, and histopathological diagnostic challenge, a case of invasive desmoplastic melanoma is reported, affecting a photoexposed area in an elderly woman after histological revisions and an initial diagnosis of fibroma.
促纤维增生性黑色素瘤是一种独特且罕见的变体，其特征为真皮和皮下组织中梭形黑素细胞增殖的浸润性病变，并伴有不同模式的促纤维增生。可能会出现嗜神经性和神经分化。临床表现多样且无特异性，容易与其他纤维性肿瘤混淆。该疾病具有局部侵袭性，转移率低于其他类型的黑色素瘤。组织病理学检查可能不够充分，需要S-100蛋白及其他黑素细胞分化抗原的免疫组化结果呈阳性。由于促纤维增生性黑色素瘤在临床、皮肤镜及组织病理学诊断方面均构成真正的挑战，本文报告了一例侵袭性促纤维增生性黑色素瘤病例，该病例发生于一名老年女性的光暴露部位，最初诊断为纤维瘤，后经组织学修正确诊。
