Abstract • In ten cases of neurotropic melanoma, patients presented with nodules composed of amelanotic, deeply infiltrating neuroid fascicles. Only four cases were clinically suggestive of melanoma. In eight of the tumors, a precursor lesion was found histologically and provided a major clue to the diagnosis. In seven cases, the dysplastic precursor was lentiginous, while a superficial spreading pattern was present in one. Initial surgery was often inadequate because of the difficulty in defining tumor margins and the lack of pigment. In seven of the tumors, S100 protein was demonstrated within the invasive spindle cell component by the immunoperoxidase method. This finding was negative in three cases, two of which showed positive staining of the precursor and nerve filaments, indicating that the absence of S100 protein cannot be used as an exclusion criterion for neurotropic melanoma. (Arch Dermatol 1987;123:907-912) References 1. Conley J, Lattes R, Orr W: Desmoplastic malignant melanoma: A rare variant of spindle cell melanoma . Cancer 1971;28:914-936.Crossref 2. Reed JR, Leonard DD: Neurotropic melanoma: A variant of desmoplastic melanoma . Am J Surg Pathol 1979;3:301-311.Crossref 3. Valensi QJ: Desmoplastic malignant melanoma: A report of two additional cases . Cancer 1977;39:286-292.Crossref 4. Labrecque PG, Hu CH, Winkelmann RK: On the nature of desmoplastic melanoma . Cancer 1976;38:1205-1213.Crossref 5. Warner TFCS, Hafez G, Buchler DA: Neurotropic melanoma of the vulva . Cancer 1982;49:999-1004.Crossref 6. McGovern VJ: Melanoma: Histological Diagnosis and Prognosis . New York, Raven Press, 1982, pp 112-114. 7. Moreno A, Lamarca J, Martinez R, et al: Osteoid and bone formation in desmoplastic malignant melanoma . J Cutan Pathol 1986;13:128-134.Crossref 8. Barr RJ, Morales RV, Graham JH: Desmoplastic nevus: A distinct histologic variant of mixed spindle and epithelioid nevus . Cancer 1980;46:557-564.Crossref 9. Dimaio SM, Mackay B, Smith JL, et al: Neurosarcomatous transformation in malignant melanoma . Cancer 1982;50:2345-2354.Crossref 10. Warner TFCS, Hafez GR, Finch RE, et al: Schwann cell features in neurotropic melanoma . J Cutan Pathol 1981;8:177-181.Crossref 11. Nakajima T, Watanabe S, Sato Y, et al: Immunohistochemical demonstration of S-100 protein in malignant melanoma and pigmented nevus, and its diagnostic application . Cancer 1982;50:912-918.Crossref 12. Warner TFCS, Lloyd RV, Hafez GR, et al: Immunochemistry of neurotropic melanoma . Cancer 1984;53:254-257.Crossref 13. Warner TFCS, Ford CN, Hafez GR: Neurotropic melanoma of the face invading the maxillary nerve . J Cutan Pathol 1985;12:520-527.Crossref 14. Stefansson K, Wollmann R, Jerkovic M: S-100 protein in soft-tissue tumors derived from Schwann cells and melanocytes . Am J Pathol 1982;106:261-268. 15. Gown AM, Vogel AM, Hoak D, et al: Monoclonal antibodies specific for melanocytic tumors distinguish subpopulations of melanocytes . Am J Pathol 1986;123:195-203.
Archives of Dermatology – American Medical Association
Published: Jul 1, 1987