(208) Fluorescence in situ hybridization testing in this manner has been demonstrated to be useful in many of the difficult scenarios that we have previously discussed, including the separation of blue nevi from blue nevus-like metastases, (209) nevoid melanoma from nevi, (210) desmoplastic melanoma
from desmoplastic nevi, (211) and cellular blue nevi from blue nevus-like melanoma, (212) and in the diagnosis of superficial lesions with suprabasal spread of melanocytes.
PDL1 expression in desmoplastic melanoma
is associated with tumor aggressiveness and progression.
Of 60 patients with desmoplastic melanoma
(DM) treated with pembrolizumab (Keytruda), nivolumab (Opdivo), or an experimental PD-L1 inhibitor (BMS 936559) and followed for a median of 22 months, 42 (70%) had an objective response to immunotherapy, including 19 patients (32%) with a complete response (CR), and 38% with a partial response, reported Antoni Ribas, MD, PhD, of the University of California, Los Angeles, and colleagues.
Neifeld, "Desmoplastic Melanoma
: Clinical Behavior and Management Implications," Eplasty, vol.
Lu, "Primary desmoplastic melanoma
of the penis," Case Reports in Urology, vol.
(18) For histology specific lifetime risk analyses, we restricted the analyses to the five most common histological subtypes based on World Health Organization (WHO)'s International Classification of Diseases for Oncology, 3rd Edition (ICD-O-3): nodular melanoma (NM) - 8721; lentigo maligna melanoma (LMM) - 8742; superficial spreading melanoma (SMM) - 8743; acral lentiginous melanoma (ALM) - 8744; and desmoplastic melanoma
(DM) - 8745.
Since it was first identified as a variant of malignant melanoma by Conley et al (1) in 1971, desmoplastic melanoma
has presented diagnostic challenges.
Venkata Ratnam, Head of Aesthetic and Reconstructive Plastic Surgery Department, at NMC Hospital in Abu Dhabi diagnosed what was initially thought to be an ulcer, successfully as Desmoplastic Melanoma
At present that's not a straightforward decision in patients with primary tumors less than 1.0 mm thick or with a desmoplastic melanoma
because their risk of metastasis to lymph nodes is considerably lower than in other melanoma patients, he said.
is most commonly found on the head and neck; however, it varies in clinical presentation (FIGURE 5).
Nevertheless, based on these validation studies, the myPath Melanoma assay has a reported sensitivity and specificity of 90% to 94% and 91% to 96%, respectively, in distinguishing melanoma from nevi and potentially lower values in desmoplastic melanoma
. However, when histologically challenging or ambiguous melanocytic lesions were included for study in a non-industry-supported comparative validation study, the myPath Melanoma assay had lower sensitivity and specificity than FISH (FISH: 69% sensitivity, 91% specificity; myPath: 55% sensitivity, 88% specificity).
SEATTLE -- Sentinel lymph node biopsy in patients with head or neck desmoplastic melanoma
is positive only 6% of the time, and it doesn't change the risk of recurrence.
 A newer melanoma marker KBA62 was evaluated and found to be positive for the desmoplastic melanoma
.  Literature also shows a case of sinonasal melanoma showing plasmacytoid variant with positive staining of CD 138, which is a plasma cell marker.
Needless to say, there are several patterns and histologic subtypes that are clinically important (e.g., desmoplastic melanoma
, nevoid melanoma, and spindle-cell melanoma).
(6,7,9) Desmoplastic melanoma
is characterized by amelanotic invasive spindled cells in a fibrotic stroma and seems to show a high propensity for perineural invasion (up to 83%).