Publication:


abstract

BACKGROUND:

Transepidermal melanocytic migration (TEM) is an important diagnostic criterion for malignancy, especially in association with cytologic atypia. However, TEM may also be observed in benign melanocytic tumors, such as Spitz nevus, acral nevi, or nevi in infancy. We discuss the value of TEM for the diagnosis of melanocytic tumors in a young patient previously diagnosed as having 11 cutaneous melanomas.

OBSERVATION:

A 17-year-old patient with a history of 11 cutaneous melanomas diagnosed in the past 3 years by different expert dermatopathologists presented in our department. The previous histological diagnoses of melanoma were mainly based on the presence of important TEM. A reevaluation of all histological specimens in light of the clinical context and the lack of genomic aberrations as detected by array-comparative genomic hybridization led to a revision of the previous diagnoses. The striking TEM observed represents, in our opinion, a Constitutional element of the melanocytic nevi in this patient and not a marker of malignancy.

CONCLUSION:

Awareness of this finding is important to avoid overdiagnosis of melanoma in cases of melanocytic nevi.

Related Articles
Review Understanding the progression of melanocytic neoplasia using genomic analysis: from fields to cancer.
Oncogene. 2003
Review Understanding the progression of melanocytic neoplasia using genomic analysis: from fields to cancer.
Bastian BC. Oncogene. 2003 May 19; 22(20):3081-6.
The usefulness of c-Kit in the immunohistochemical assessment of melanocytic lesions.
Eur J Histochem. 2011
The usefulness of c-Kit in the immunohistochemical assessment of melanocytic lesions.
Pilloni L, Bianco P, Difelice E, Cabras S, Castellanos ME, Atzori L, Ferreli C, Mulas P, Nemolato S, Faa G. Eur J Histochem. 2011 Jun 7; 55(2):e20. Epub 2011 Jun 7.
Acral melanocytic neoplasms: a histologic analysis of 158 lesions.
J Am Acad Dermatol. 1994
Acral melanocytic neoplasms: a histologic analysis of 158 lesions.
Boyd AS, Rapini RP. J Am Acad Dermatol. 1994 Nov; 31(5 Pt 1):740-5.
In vivo assessment of melanocytic nests in nevi and melanomas by reflectance confocal microscopy.
Mod Pathol. 2005
In vivo assessment of melanocytic nests in nevi and melanomas by reflectance confocal microscopy.
Pellacani G, Cesinaro AM, Seidenari S. Mod Pathol. 2005 Apr; 18(4):469-74.
Review Pagetoid melanocytosis: tease or tocsin?
Semin Diagn Pathol. 1998
Review Pagetoid melanocytosis: tease or tocsin?
Stern JB, Haupt HM. Semin Diagn Pathol. 1998 Aug; 15(3):225-9.