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Nodular Melanoma

slide 54 of 83

Comments:
Nodular melanoma (NM) accounts for 3-4% of all melanoma cases. It occurs in a relatively younger age group (5th or 6th decades) than other melanoma subtypes and is of shorter duration. Males are affected more commonly than females (M:F = 2:1). It can present anywhere on the body surface but has a predilection for trunk and limbs. It appears as a smooth firm elevated nodule or a polypoid mass covered by epidermis. The color ranges from tan (amelanotic variants), brown, blue to black. Some cases show ulceration. By definition, it does not have a radial growth phase, hence a flat pigmented component is not seen clinically or microscopically in the adjoining skin. Amelanotic variants may be mistaken for pyogenic granuloma or other vascular lesions.

This is image of longitudinal section through the previous specimen (Slide 51). The vertical (invasive) component can be clearly seen due to melanin pigment. The tumor invaded through reticular dermis into subcutaneous fat (Clark Level 5).

slide 54 of 83