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Journal of the European Academy of Dermatology and Venereology : JEADV
Jun, 2021;35 (6): 1290-1298.

Desmoplastic melanoma: a review of its pathology and clinical behaviour, and of management recommendations in published guidelines.

T M Hughes, G J Williams, D E Gyorki, J W Kelly, J R Stretch, A H R Varey, A M Hong, R A Scolyer, J F Thompson
Author Information
  1. T M Hughes: Cancer Council Australia Melanoma Guidelines Working Party, Sydney, NSW, Australia. ORCID
  2. G J Williams: Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia. ORCID
  3. D E Gyorki: Cancer Council Australia Melanoma Guidelines Working Party, Sydney, NSW, Australia. ORCID
  4. J W Kelly: Cancer Council Australia Melanoma Guidelines Working Party, Sydney, NSW, Australia. ORCID
  5. J R Stretch: Cancer Council Australia Melanoma Guidelines Working Party, Sydney, NSW, Australia. ORCID
  6. A H R Varey: Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia. ORCID
  7. A M Hong: Cancer Council Australia Melanoma Guidelines Working Party, Sydney, NSW, Australia. ORCID
  8. R A Scolyer: Cancer Council Australia Melanoma Guidelines Working Party, Sydney, NSW, Australia. ORCID
  9. J F Thompson: Cancer Council Australia Melanoma Guidelines Working Party, Sydney, NSW, Australia. ORCID
PMID: 33544941 DOI: 10.1111/jdv.17154

Abstract

desmoplastic melanomas are uncommon. Their behaviour differs from that of other melanoma subtypes; therefore, management guidelines for non-desmoplastic melanomas may not be applicable. This review sought to examine all available evidence relating to the behaviour and management of desmoplastic melanomas, based on review of all relevant English-language publications, and to critically assess the recommendations for their management in current published melanoma management guidelines. Compared with other melanoma subtypes, patients with 'pure' desmoplastic melanomas (where ≥90% of the invasive melanoma is of desmoplastic melanoma subtype) have much lower rates of sentinel node positivity and distant metastasis. Local recurrence rates are higher for desmoplastic melanomas, but resection margins wider than those recommended for non-desmoplastic melanomas have not been shown to be of benefit. Adjuvant radiotherapy reduces the risk of local recurrence when a satisfactory histological clearance (≥8 mm) cannot be achieved. Of 29 published melanoma management guidelines identified, only 11 specified management for desmoplastic melanomas, while seven simply stated that the feature should be reported. Desmoplastic melanoma is a unique melanoma subtype with biology that differs from that of other melanoma subtypes. It requires specific management strategies but few current guidelines address these.

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Grants

  1. /Melanoma Institute Australia
  2. /Melanoma Foundation of the University of Sydney
  3. APP1093017/National Health and Medical Research Council

MeSH Term

Humans
Margins of Excision
Melanoma
Skin Neoplasms
Journal Article Review
Article has an altmetric score of 1

Word Cloud

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