Ann Dermatol.  2009 May;21(2):185-188. 10.5021/ad.2009.21.2.185.

Progression from Acral Lentiginous Melanoma in situ to Invasive Acral Lentiginous Melanoma

• Bae JM
• Kim HO
• Park YM

• KMID: 2219393
• DOI: http://doi.org/10.5021/ad.2009.21.2.185

Abstract

Acral lentiginous melanoma (ALM) is the most common type of cutaneous melanoma in Asians. The very early stage of ALM demonstrates only a proliferation of a few atypical melanocytes within the epidermis, and has been termed ALM in situ. A 74-year-old male patient presented with a pigmented lesion on the left great toe for 12 years, which had initially showed only a few scattered hyperplastic atypical melanocytes without dermal invasion upon biopsy 5 years ago. This time however, rebiopsy of the lesion confirmed a diagnosis of ALM, stage IIIB. It could be inferred that the lesion had slowly progressed from ALM in situ to invasive ALM over a period of 12 years. Herein we report a case of ALM in situ which progressed to invasive ALM over a long period of time. We expect this report may assist physicians in early recognition and proper management of future cases of ALM in situ.

Keyword

Acral lentiginous melanoma in situ

MeSH Terms

Aged
Asian Continental Ancestry Group
Biopsy
Epidermis
Humans
Male
Melanocytes
Melanoma
Toes

Figure

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  Fig. 1 Acral lentiginous melanoma in situ 5 years ago. (A) Clinical photograph, (B) Histopathologic findings show minimal atypical melanocytic hyperplasia without dermal invasion (hematoxylin and eosin, ×400).

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  Fig. 2 (A, B) Invasive acral lentiginous melanoma. (C, D) Clinical photographs. The histopathologic findings show nest formation by melanoma cells (hematoxylin and eosin, C: ×100, D: ×400).

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