Neurotropic melanoma

Abstract

A group of neuroid, cutaneous tumors that are usually associated with, or preceded by a melanocytic dysplasia was studied. For this clinicopathologic entity the term neurotropic melanoma was chosen. The neurotropic melanoma is a cutaneous fibrous tumor whose clinical course is characterized by local infiltration, multiple recurrences and commonly by metastases. Its microscopic picture is characterized by atypical neuroma-like patterns, by poorly defined margins and by neurotropism. Its early or precursory melanocytic dysplasias include lentigo maligna (actinic or lentigo maligna variant), and a melanoma with borderline cytologic characteristics (minimal deviation variant). A third type is not preceded by a recognizable melanocytic dysplasia: it has neuroma-like qualities at its inception (de novo variant). In the 22 cases, the preponderant sites were the head, neck and lip. The patients were fair-faced and 18 of the patients were over 40 yr old. Seventeen patients had 1 or more recurrences. Of 16 patients with follow-up, 9 died with evidence of disease, 5 are alive with active disease and 7 are apparently free of disease.