Melanoma nodular C43.L

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Melanoma nodular type; Nodular malignant melanoma; Nodular melanoma; Nodular melanomalignoma; Primary nodular melanoma

Definition
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Aggressive and vertically growing malignant melanoma with a rather bad prognosis (5-JÜR depending on tumor thickness at 60%). Occurs mainly in fair-skinned, intensely sun-exposed people, either on previously unmodified skin (more rarely), or on a pre-existing melanocytic nevus. Nodular melanoma is the second most common form of melanoma (20-30% of all melanomas).

Manifestation
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m>w; preferred for skin types I and II; age: >50 years

Localization
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torso, head, neck

Clinical features
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One distinguishes between two forms of growth:

  • Vertical type: Small, black or blue-black, smooth, hemispherical knot.
  • Vertical/horizontal type: Black, irregularly configured node with horizontal and vertical growth. The nodule shows a thinned, parchment-like, also exfoliatively scaly surface. Not uncommon are crust formations or central erosions or ulcerations (bleeding and weeping). At the edge of the nodule tongue-shaped, brown, black or red plaques are found.

Incident light microscopy: Diffuse pigmentation is dominant, the regular pigment network may still be present at the edge.

High-resolution sonography: echoless tumor zone. Suitable for non-invasive thickness determination of the tumor parenchyma.

Histology
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Spindly, epithelioid and polymorphic melanoma cells in the epidermis and dermis, extending into the subcutaneous fatty tissue. Strong inflammatory stroma reaction.

Therapy
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Corresponding to the malignant melanoma.

Progression/forecast
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Unfavorable, early invasive growth.

Literature
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Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020