Melanoma amelanotic C43.L

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Amelanotic malignant melanoma; Amelanotic melanoma

Definition
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Rare (about 2-8% of all melanomas), low-pigment or pigment-free form of malignant melanoma, which is mainly observed in people with skin type I.

Localization
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Any body region that is also characteristic of other melanoma types (see below melanoma, malignant) can be affected.

Clinical features
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Little characteristic clinical picture. Mostly clinically asymptomatic, little noticed, red, reddish-brown or skin-coloured, 0.2-1.0 -2.0 cm plaque/nodules with smooth, eroded or ulcerated, also crusty surface. The discoloration of an originally dark coloured malignant melanoma can apply to all tumour types. In this respect the clinical variability is very large. This also applies to its almost ubiquitous localisation.

The so-called ABCD rule is only partially applicable:

  • A = Asymmetry (unequal halves on both sides of an imaginary centre line) - applies
  • B = Border irregularity - applies
  • C = Colour variation, especially the occurrence of brown and black tones(most important criterion - not applicable)
  • D = Diameter (diameter): more than 5 mm or size growth (applicable)

Incident light microscopy: reddish or skin-coloured nodules, possibly remains of the pigment network.

High-resolution sonography (see sonography, 20 MHz sonography): see malignant melanoma.

Histology
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Detection of melanin is often only possible with special colourings (silver plating).

Direct Immunofluorescence
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HMB 45 and S100 positive cells.

Differential diagnosis
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Therapy
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Corresponding to the malignant melanoma.

Progression/forecast
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Less favourable than in pigmented melanomas, since amelanotic malignant melanomas become clinically symptomatic at a late stage or are only discovered by chance.

Literature
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  1. Eagle MJ, White CR (1997) Amelanotic malignant melanoma. Semin Cutan Med Surg 16: 122-130
  2. Peterson J, Rowley M (2007) Rhinophymatous amelanotic melanoma. Cutis 79: 383-386
  3. Yesil S et al (2007) Amelanotic melanoma misdiagnosed as a diabetic foot ulcer. J Diabetes Complications 21: 335-337

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020