Melanocytic Slide ClubCase 201

Dr Richard A. Carr

M11. Lesion on forearm

Summary of EQA Participant Responses (N=28)

• Spitz Naevus 10• DPN 2• Blue Naevus 1• Atypical / Borderline 10

– Note: includes most of the above responders

• Melanoma 12– Spitzoid 1– SSMM: 2– LMM 1– Desmoplastic 1– Malignant Blue 1– Unclassifiable 4

Results (N=28)• Clark level:

– IV 1– V 12

• Breslow– Median (Range): 4.2 (3.5 to 6.3)

• Growth Phase– VGP 12– RGP 0

• Regression: Y/N 1/11• Mitotic Rate:

– Absent: 1– Low: 11– High: 0

Atypical Spitz: “Difficult Spitzoid, Lateral Spread”

DPN (UMP): “Manage as melanoma but in view of age and sparse mitoses consider DPN”

DPN (UMP): “Difficult - possible atypical deep penetrating naevus- I would suggest uncertain malignant potential as I certainly would not wish to exclude melanoma. History important. Sentinel node would be of interest”

Melanoma: “Very tricky case in a child. Has there been previous treatment/trauma?”

Slide Club: Expert Comments