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Published in: Dermatology and Therapy 12/2022

Open Access 04-11-2022 | Melanoma | Case Series

Characteristics of Giant Nodular Melanomas in Special Locations: a Case Series and Review of the Literature

Authors: Grażyna Kamińska-Winciorek, Katarzyna Galwas, Magdalena Suchorzepka, Barbara Ziółkowska, Maria Turska-d’Amico, Wiesław Bal, Claudio Conforti, Ludovica Toffoli, Bożena Cybulska-Stopa, Iris Zalaudek

Published in: Dermatology and Therapy | Issue 12/2022

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Abstract

Introduction

Nodular melanoma (NM) is a rare subtype of melanoma, responsible for more than 40% of melanoma deaths, characterized by rapid growth and high metastatic potential. Only a few case studies concerning the dermoscopic presentations of giant nodular melanoma have been reported so far.

Objectives

The aim of the study was to assess dermoscopic features of giant nodular melanomas in special locations, along with their clinical and histopathologic aspects.

Methods

Among 120 patients with histopathologically confirmed melanoma treated by the Skin Cancer and Melanoma Team between September 2020 and February 2021, we identified six patients with giant nodular melanoma in special locations. We retrospectively assessed the archived dermoscopic images to determine the dermoscopic features of these tumors.

Results

The group consisted of six cases of giant melanoma in special locations, including the scalp (4/6) and the heel (2/6). The giant tumors were large in size (at least 5 cm in diameter). The most common dermoscopic structures in polarized light included asymmetric distribution of dermoscopic structures, the presence of structureless, multicolored zones (showing three or more colors), and the presence of white perpendicular lines or small, pink globules.

Conclusions

It seems that there are no significant differences in dermoscopy between small and giant melanomas; however, further studies should be conducted on a larger scale.
Literature
1.
go back to reference Corneli P, Zalaudek I, Magaton Rizzi G, et al. Improving the early diagnosis of early nodular melanoma: can we do better? Expert Rev Anticancer Ther. 2018;18:1007–12.CrossRefPubMed Corneli P, Zalaudek I, Magaton Rizzi G, et al. Improving the early diagnosis of early nodular melanoma: can we do better? Expert Rev Anticancer Ther. 2018;18:1007–12.CrossRefPubMed
2.
go back to reference Di Altobrando A, Patrizi A, Dika E, et al. Cauliflower-like exophytic mass on the skin: polypoid melanoma. Clinical, dermoscopic, and histologic features. An Bras Dermatol. 2020;95:748–50.CrossRefPubMedPubMedCentral Di Altobrando A, Patrizi A, Dika E, et al. Cauliflower-like exophytic mass on the skin: polypoid melanoma. Clinical, dermoscopic, and histologic features. An Bras Dermatol. 2020;95:748–50.CrossRefPubMedPubMedCentral
3.
go back to reference Argenziano G, Longo C, Cameron A, et al. Blue-black rule: a simple dermoscopic clue to recognize pigmented nodular melanoma. Br J Dermatol. 2011;165:1251–5.CrossRefPubMed Argenziano G, Longo C, Cameron A, et al. Blue-black rule: a simple dermoscopic clue to recognize pigmented nodular melanoma. Br J Dermatol. 2011;165:1251–5.CrossRefPubMed
4.
go back to reference Pizzichetta MA, Kittler H, Stanganelli I, et al. Italian Melanoma Intergroup. Pigmented nodular melanoma: the predictive value of dermoscopic features using multivariate analysis. Br J Dermatol. 2015;173:106–14.CrossRefPubMed Pizzichetta MA, Kittler H, Stanganelli I, et al. Italian Melanoma Intergroup. Pigmented nodular melanoma: the predictive value of dermoscopic features using multivariate analysis. Br J Dermatol. 2015;173:106–14.CrossRefPubMed
5.
go back to reference Rosendahl C, Hishon M, Cameron A, et al. Nodular melanoma: five consecutive cases in a general practice with polarized and non-polarized dermatoscopy and dermatopathology. Dermatol Pract Concept. 2014;4:69–75.PubMedPubMedCentral Rosendahl C, Hishon M, Cameron A, et al. Nodular melanoma: five consecutive cases in a general practice with polarized and non-polarized dermatoscopy and dermatopathology. Dermatol Pract Concept. 2014;4:69–75.PubMedPubMedCentral
6.
go back to reference Menzies SW, Moloney FJ, Byth K, et al. Dermoscopic evaluation of nodular melanoma. JAMA Dermatol. 2013;149:699–709.CrossRefPubMed Menzies SW, Moloney FJ, Byth K, et al. Dermoscopic evaluation of nodular melanoma. JAMA Dermatol. 2013;149:699–709.CrossRefPubMed
7.
go back to reference Niforou A, Sgouros D, Lallas A, IDS Thin NM Project Investigators, et al. The spectrum of morphologic patterns of nodular melanoma: a study of the International Dermoscopy Society. J Eur Acad Dermatol Venereol. 2021;35:e762–5.CrossRefPubMed Niforou A, Sgouros D, Lallas A, IDS Thin NM Project Investigators, et al. The spectrum of morphologic patterns of nodular melanoma: a study of the International Dermoscopy Society. J Eur Acad Dermatol Venereol. 2021;35:e762–5.CrossRefPubMed
8.
go back to reference Bono A, Tolomio E, Carbone A, et al. Small nodular melanoma: the beginning of a life-threatening lesion. A clinical study on 11 cases. Tumori. 2011;97:35–8.CrossRefPubMed Bono A, Tolomio E, Carbone A, et al. Small nodular melanoma: the beginning of a life-threatening lesion. A clinical study on 11 cases. Tumori. 2011;97:35–8.CrossRefPubMed
9.
go back to reference Megna M, Ruggiero A, Fabbrocini G, et al. Giant nodular melanoma of the nose in a 78-year-old female refusing complete excision. Dermatol Ther. 2020;33: e14056.CrossRefPubMed Megna M, Ruggiero A, Fabbrocini G, et al. Giant nodular melanoma of the nose in a 78-year-old female refusing complete excision. Dermatol Ther. 2020;33: e14056.CrossRefPubMed
10.
go back to reference Kiyak MV, Yesilada AK, Sevim KZ, et al. Giant malignant melanoma: a case report. Acta Chir Plast. 2012;54:59–61.PubMed Kiyak MV, Yesilada AK, Sevim KZ, et al. Giant malignant melanoma: a case report. Acta Chir Plast. 2012;54:59–61.PubMed
12.
go back to reference Benmeir P, Neuman A, Weinberg A, et al. Giant melanoma of the inner thigh: a homeopathic life-threatening negligence. Ann Plast Surg. 1991;27:583–5.CrossRefPubMed Benmeir P, Neuman A, Weinberg A, et al. Giant melanoma of the inner thigh: a homeopathic life-threatening negligence. Ann Plast Surg. 1991;27:583–5.CrossRefPubMed
13.
go back to reference Kaminska-Winciorek G, Zalaudek I, Wozniak Z, et al. An unusual case of compound naevus of the scalp with hair greying, suggesting melanoma in dermoscopy. Postepy Dermatol Alergol. 2020;37:274–6.CrossRefPubMedPubMedCentral Kaminska-Winciorek G, Zalaudek I, Wozniak Z, et al. An unusual case of compound naevus of the scalp with hair greying, suggesting melanoma in dermoscopy. Postepy Dermatol Alergol. 2020;37:274–6.CrossRefPubMedPubMedCentral
14.
go back to reference Hofmann-Wellenhof R. Special criteria for special locations 2: scalp, mucosal, and milk line. Dermatol Clin. 2013;31:625–36.CrossRefPubMed Hofmann-Wellenhof R. Special criteria for special locations 2: scalp, mucosal, and milk line. Dermatol Clin. 2013;31:625–36.CrossRefPubMed
15.
go back to reference Mun JH, Jo G, Darmawan CC, et al. Association between Breslow thickness and dermoscopic findings in acral melanoma. J Am Acad Dermatol. 2018;79:831–5.CrossRefPubMed Mun JH, Jo G, Darmawan CC, et al. Association between Breslow thickness and dermoscopic findings in acral melanoma. J Am Acad Dermatol. 2018;79:831–5.CrossRefPubMed
16.
go back to reference Sgouros D, Lallas A, Kittler H, et al. Dermatoscopic features of thin (≤2 mm Breslow thickness) vs. thick (>2 mm Breslow thickness) nodular melanoma and predictors of nodular melanoma versus nodular non-melanoma tumours: a multicentric collaborative study by the International Dermoscopy Society. J Eur Acad Dermatol Venereol. 2020;34:2541–7.CrossRefPubMedPubMedCentral Sgouros D, Lallas A, Kittler H, et al. Dermatoscopic features of thin (≤2 mm Breslow thickness) vs. thick (>2 mm Breslow thickness) nodular melanoma and predictors of nodular melanoma versus nodular non-melanoma tumours: a multicentric collaborative study by the International Dermoscopy Society. J Eur Acad Dermatol Venereol. 2020;34:2541–7.CrossRefPubMedPubMedCentral
17.
go back to reference Suppa M, Micantonio T, Di Stefani A, et al. Dermoscopic variability of basal cell carcinoma according to clinical type and anatomic location. J Eur Acad Dermatol Venereol. 2015;29:1732–41.CrossRefPubMed Suppa M, Micantonio T, Di Stefani A, et al. Dermoscopic variability of basal cell carcinoma according to clinical type and anatomic location. J Eur Acad Dermatol Venereol. 2015;29:1732–41.CrossRefPubMed
18.
go back to reference Fagotti S, Pizzichetta MA, Corneli P, et al. Dermoscopic features of face and scalp basal and squamous cell carcinomas according to clinical histopathologic characteristics and anatomical location. J Eur Acad Dermatol Venereol. 2021;35:e237–9.CrossRefPubMed Fagotti S, Pizzichetta MA, Corneli P, et al. Dermoscopic features of face and scalp basal and squamous cell carcinomas according to clinical histopathologic characteristics and anatomical location. J Eur Acad Dermatol Venereol. 2021;35:e237–9.CrossRefPubMed
19.
go back to reference Lin MJ, Pan Y, Jalilian C, Kelly JW. Dermoscopic characteristics of nodular squamous cell carcinoma and keratoacanthoma. Dermatol Pract Concept. 2014;4:9–15.PubMedPubMedCentral Lin MJ, Pan Y, Jalilian C, Kelly JW. Dermoscopic characteristics of nodular squamous cell carcinoma and keratoacanthoma. Dermatol Pract Concept. 2014;4:9–15.PubMedPubMedCentral
20.
go back to reference Ciudad C, Avilés JA, Alfageme F, Lecona M, Suárez R, Lázaro P. Spontaneous regression in Merkel cell carcinoma: report of two cases with a description of dermoscopic features and review of the literature. Dermatol Surg. 2010;36:687–93.CrossRefPubMed Ciudad C, Avilés JA, Alfageme F, Lecona M, Suárez R, Lázaro P. Spontaneous regression in Merkel cell carcinoma: report of two cases with a description of dermoscopic features and review of the literature. Dermatol Surg. 2010;36:687–93.CrossRefPubMed
21.
go back to reference Moscarella E, Piana S, Specchio F, et al. Dermoscopy features of atypical fibroxanthoma: a multicenter study of the International Dermoscopy Society. Australas J Dermatol. 2018;59:309–14.CrossRefPubMed Moscarella E, Piana S, Specchio F, et al. Dermoscopy features of atypical fibroxanthoma: a multicenter study of the International Dermoscopy Society. Australas J Dermatol. 2018;59:309–14.CrossRefPubMed
22.
go back to reference Di Brizzi EV, Moscarella E, Piana S, et al. Clinical and dermoscopic features of pleomorphic dermal sarcoma. Australas J Dermatol. 2019;60:e153–4.CrossRefPubMed Di Brizzi EV, Moscarella E, Piana S, et al. Clinical and dermoscopic features of pleomorphic dermal sarcoma. Australas J Dermatol. 2019;60:e153–4.CrossRefPubMed
23.
go back to reference Minagawa A, Koga H, Okuyama R. Vascular structure absence under dermoscopy in two cases of angiosarcoma on the scalp. Int J Dermatol. 2014;53:e350-352.CrossRefPubMed Minagawa A, Koga H, Okuyama R. Vascular structure absence under dermoscopy in two cases of angiosarcoma on the scalp. Int J Dermatol. 2014;53:e350-352.CrossRefPubMed
24.
go back to reference Oiso N, Matsuda H, Kawada A. Various colour gradations as a dermatoscopic feature of cutaneous angiosarcoma of the scalp. Australas J Dermatol. 2013;54:36–8.CrossRefPubMed Oiso N, Matsuda H, Kawada A. Various colour gradations as a dermatoscopic feature of cutaneous angiosarcoma of the scalp. Australas J Dermatol. 2013;54:36–8.CrossRefPubMed
25.
go back to reference Cochran AJ, Bastian, BC, Elder DE. Nodular, nevoid and metastatic melanoma. In: WHO Classification of skin tumours, 4th edn. Lyon: International Agency for Research on Cancer IARC; 2018. p. 145–146. Cochran AJ, Bastian, BC, Elder DE. Nodular, nevoid and metastatic melanoma. In: WHO Classification of skin tumours, 4th edn. Lyon: International Agency for Research on Cancer IARC; 2018. p. 145–146.
26.
go back to reference Cochran AJ, Elder DE, Lowe L, et al. Classification of skin tumours, metastatic melanoma. In: WHO Classification of Skin Tumours, 4th edn. Lyon: International Agency for Research on Cancer IARC; 2018. p. 150–152. Cochran AJ, Elder DE, Lowe L, et al. Classification of skin tumours, metastatic melanoma. In: WHO Classification of Skin Tumours, 4th edn. Lyon: International Agency for Research on Cancer IARC; 2018. p. 150–152.
27.
go back to reference Elder DE, Bastian BC, Cree IA, et al. The 2018 world health organization classification of cutaneous, mucosal, and uveal melanoma: detailed analysis of 9 distinct subtypes defined by their evolutionary pathway. Arch Pathol Lab Med. 2020;144:500–22.CrossRefPubMed Elder DE, Bastian BC, Cree IA, et al. The 2018 world health organization classification of cutaneous, mucosal, and uveal melanoma: detailed analysis of 9 distinct subtypes defined by their evolutionary pathway. Arch Pathol Lab Med. 2020;144:500–22.CrossRefPubMed
Metadata
Title
Characteristics of Giant Nodular Melanomas in Special Locations: a Case Series and Review of the Literature
Authors
Grażyna Kamińska-Winciorek
Katarzyna Galwas
Magdalena Suchorzepka
Barbara Ziółkowska
Maria Turska-d’Amico
Wiesław Bal
Claudio Conforti
Ludovica Toffoli
Bożena Cybulska-Stopa
Iris Zalaudek
Publication date
04-11-2022
Publisher
Springer Healthcare
Published in
Dermatology and Therapy / Issue 12/2022
Print ISSN: 2193-8210
Electronic ISSN: 2190-9172
DOI
https://doi.org/10.1007/s13555-022-00841-8

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