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皮肤痣样黑色素瘤:一项关于临床病理特征的回顾性研究,重点关注皮肤镜特征和生存分析。

Cutaneous Nevoid Melanoma: A Retrospective Study on Clinico-Pathological Characteristics, with a Focus on Dermoscopic Features and Survival Analysis.

作者信息

Russo Irene, Sartor Emma, Cappellesso Rocco, Salmaso Roberto, Del Fiore Paolo, Sartor Gino, Vecchiato Antonella, Alaibac Mauro, Mocellin Simone

机构信息

Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy.

Dermatology Unit, Department of Medicine, University of Padova, 35128 Padua, Italy.

出版信息

Cancers (Basel). 2024 Dec 29;17(1):65. doi: 10.3390/cancers17010065.

Abstract

Diagnosis of nevoid melanoma (NeM) is often difficult because NeM closely resembles a common nevus clinically and histologically. A retrospective study was conducted on 110 patients diagnosed with and/or treated for primary nevoid melanoma at the Veneto Institute of Oncology and at the University Hospital of Padua from August 1999. Mean Breslow thickness was of 1.4 mm. Sentinel lymph node biopsy was conducted in nearly half of the patients, and positivity was detected in 16.7% of them. Twenty-four clinical and 23 dermoscopic pictures were collected. Papular and macular lesions prevailed over nodular and plaque-type lesions. Different hues of brown, pink, and red color were most represented. Twenty nevus-like NeMs and four multicomponent-pattern NeMs were observed. The Most frequent dermoscopic patterns for nevus-like NeM were atypical pigmented reticulum, irregular globules and dots, and hyperpigmented blotches. Atypical vessels, asymmetric peripheric striae, blue-white veil, and areas of regression were less frequent and prevailed in multicomponent pattern NeM. A structureless pattern was also featured. Many patients in the series had multiple melanomas. However, none of them had numerous multiple nevoid melanomas. NeM should not be regarded as a separate biological entity from classical melanoma, and the same histological and clinical prognostic factors apply to NeM. Clinically and dermoscopically, it often resembles benign nevi, although some clues such as evolution and some dermoscopic patterns could suggest malignancy. Clinical suspicion might prove crucial to further pathological analysis and recognition.

摘要

痣样黑色素瘤(NeM)的诊断往往很困难,因为NeM在临床和组织学上与普通痣极为相似。对1999年8月以来在威尼托肿瘤研究所和帕多瓦大学医院被诊断为原发性痣样黑色素瘤并接受治疗的110例患者进行了一项回顾性研究。平均Breslow厚度为1.4毫米。近一半的患者进行了前哨淋巴结活检,其中16.7%检测为阳性。收集了24张临床图片和23张皮肤镜图片。丘疹性和斑疹性病变多于结节性和斑块型病变。棕色系、粉色系和红色系的不同色调最为常见。观察到20例痣样NeM和4例多成分型NeM。痣样NeM最常见的皮肤镜表现为非典型色素性网状结构、不规则小球和斑点以及色素沉着斑。非典型血管、不对称周边条纹、蓝白色面纱和消退区域较少见,多在多成分型NeM中出现。还呈现出无结构模式。该系列中的许多患者患有多发性黑色素瘤。然而,他们中没有一人患有大量多发性痣样黑色素瘤。NeM不应被视为与经典黑色素瘤不同的生物学实体,相同的组织学和临床预后因素适用于NeM。在临床和皮肤镜检查中,它通常类似于良性痣,尽管一些诸如演变和某些皮肤镜表现等线索可能提示恶性。临床怀疑对于进一步的病理分析和识别可能至关重要。

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