Superficial spreading melanoma

Nodular (NM) and superficial spreading melanoma (SSM) show different disease trajectories, with more rapid development in NM and fewer opportunities for early detection often resulting in worse outcomes. Our study described the patient-identified early signs of thin NM via comparisons to thin (≤ 2 mm) SSM and thick (> 2 mm) NM.

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Melanoma accounts for the majority of skin cancer deaths. It has over thirty different subtypes. Different races have been observed to differ in multiple aspects of melanoma. Racial differences exist for the six major melanoma subtypes in the U.S. More data collection and analysis are needed to fully describe and interpret the differences across racial groups and across subtypes.

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Although rare, cytology of signet ring cell melanoma has been on record. Tsang et al. (1993) documented a case that manifested as a groin mass in a patient who had undergone below knee amputation for superficial spreading melanoma of the right foot. FNA smears in this case showed poorly cohesive, large cells with eccentric nuclei, most of which exhibited signet ring morphology. Only a small proportion of cells displayed melanin pigment clinching the right diagnosis.

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Melanoma Pigmented lesions are among the most common findings on skin examination. The challenge is to distinguish cutaneous melanomas, which may be lethal, from the remainder, which with rare exceptions are benign. Examples of malignant and benign pigmented lesions are shown in Fig. 83-1. Figure 83-1 Atypical and malignant pigmented lesions. The most common melanoma is superficial spreading melanoma (not pictured).

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Clinical Characteristics There are four types of cutaneous melanoma (Table 83-2). In three of these—superficial spreading melanoma, lentigo maligna melanoma, and acral lentiginous melanoma—the lesion has a period of superficial (so-called radial) growth during which it increases in size but does not penetrate deeply. It is during this period that the melanoma is most capable of being cured by surgical excision. The fourth type—nodular melanoma—does not have a recognizable radial growth phase and usually presents as a deeply invasive lesion, capable of early metastasis.

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Harrison's Internal Medicine Chapter 83. Cancer of the Skin Melanoma Pigmented lesions are among the most common findings on skin examination. The challenge is to distinguish cutaneous melanomas, which may be lethal, from the remainder, which with rare exceptions are benign. Examples of malignant and benign pigmented lesions are shown in Fig. 83-1. Figure 83-1 Atypical and malignant pigmented lesions. The most common melanoma is superficial spreading melanoma (not pictured). A.

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