Desmoplastic melanoma of the skin: current aspects of morphological and immunohistochemical diagnosis

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Abstract

To study the clinical, morphological, and immunohistochemical characteristics of desmoplastic melanoma and the use of modern diagnostic technologies to refine the classification criteria for this rare subtype of malignant neoplasms. The study included 5 patients (4 men and 1 woman, median age 62.5 years) diagnosed with malignant neoplasms of the skin on the back (3 cases) and the buccal area of the face (2 cases). Morphological and immunohistochemical studies were performed using markers S100 and Melan-A to confirm the diagnosis. Modern technologies were applied to improve diagnostic accuracy. Morphological analysis revealed the characteristic dense collagenized stroma and low cellular density of desmoplastic melanoma tumors. Immunohistochemical analysis confirmed the melanocytic origin of the tumors. The use of modern diagnostic methods allows us to determine diagnostic and classification criteria for desmoplastic melanoma. A comprehensive approach, including morphological and immunohistochemical methods with markers S100 and Melan-A, enhances diagnostic accuracy and refines the classification criteria for this disease.

About the authors

Dalgat R. Makhachev

Pirogov Russian National Research Medical University (Pirogov University)

Author for correspondence.
Email: Dalgat2002@mail.ru
ORCID iD: 0009-0007-0930-5272
SPIN-code: 4064-6451
Russian Federation, Moscow

Dmitry V. Bulanov

Pirogov Russian National Research Medical University (Pirogov University)

Email: dbulanov81@gmail.com
ORCID iD: 0009-0005-3772-6643
SPIN-code: 2641-6658

MD, Cand. Sci. (Med.), Assistant Professor

Russian Federation, Moscow

Maryam U. Shikhsaidova

Pirogov Russian National Research Medical University (Pirogov University)

Email: mary6545566@mail.ru
ORCID iD: 0009-0002-1471-7005
Russian Federation, Moscow

Madina N. Magomedova

Pirogov Russian National Research Medical University (Pirogov University)

Email: madimagm6@gmail.com
ORCID iD: 0009-0005-1439-4201
Russian Federation, Moscow

Kheda A. Saipova

Pirogov Russian National Research Medical University (Pirogov University)

Email: saipovak@list.ru
ORCID iD: 0009-0009-0435-1039
Russian Federation, Moscow

Dinara I. Ibragimova

Dagestan State Medical University

Email: dinaaarush@gmail.com
ORCID iD: 0009-0007-9672-8133
Russian Federation, Makhachkala

References

  1. Gosman LM, ăpoi DA, Costache M. Cutaneous melanoma: a review of multifactorial pathogenesis, immunohistochemistry, and emerging biomarkers for early detection and management. Int J Mol Sci. 2023;24(21):15881. doi: 10.3390/ijms242115881
  2. Gieniusz E, Skrzydlewska E, Łuczaj W. Current insights into the role of UV radiation-induced oxidative stress in melanoma pathogenesis. Int J Mol Sci. 2024;25(21):11651. doi: 10.3390/ijms252111651
  3. Plaza JA, Bonneau P, Prieto VG, Sangueza M, Mackinnon A, Suster D, et al. Desmoplastic melanoma: an updated immunohistochemical analysis of 40 cases with a proposal for an additional panel of stains for diagnosis. J Cutan Pathol. 2016;43(4):313–323. doi: 10.1111/cup.12654
  4. Tinca AC, Marinescu MA, Bratu O, Gheorghe M, Mischianu DL, Sajin M. Actualities in the morphology and immunohistochemistry of cutaneous and ocular melanoma: what lies ahead? A single-centre study. Biomedicines. 2022;10(10):2500. doi: 10.3390/biomedicines10102500
  5. ăpoi DA, Gheorghișan-Gălăeanu AA, Dumitru AV, Luca AC, Costache M, Furtunescu AR, et al. Primary undifferentiated/dedifferentiated cutaneous melanomas — a review on histological, immunohistochemical, and molecular features with emphasis on prognosis. Int J Mol Sci. 2023;24(12):9985. doi: 10.3390/ijms24129985
  6. Machado I, Llombart B, Cruz J, Traves V, Requena C, Nagore E, et al. Desmoplastic melanoma may mimic a cutaneous peripheral nerve sheath tumor: report of 3 challenging cases. J Cutan Pathol. 2017;44(7):632–638. doi: 10.1111/cup.12949
  7. Marques PC, Diniz LM, Spelta K, Nogueira PSE. Desmoplastic melanoma: a rare variant with challenging diagnosis. An Bras Dermatol. 2019;94(1):82–85. doi: 10.1590/abd1806-4841.20197481
  8. Frydenlund N, Mahalingam M. Desmoplastic melanoma, neurotropism, and neurotrophin receptors — what we know and what we do not. Adv Anat Pathol. 2015;22(4):227–241. doi: 10.1097/PAP.0000000000000076
  9. Manfredini M, Pellacani G, Losi L, Maccaferri M, Tomasi A, Ponti G. Desmoplastic melanoma: a challenge for the oncologist. Future Oncol. 2017;13(4):337–345. doi: 10.2217/fon-2016-0334
  10. McCarthy SW, Scolyer RA, Palmer AA. Desmoplastic melanoma: a diagnostic trap for the unwary. Pathology. 2004;36(5):445–451. doi: 10.1080/00313020412331285336
  11. Ugolini F, Pasqualini E, Simi S, Baroni G, Massi D. Bright-field multiplex immunohistochemistry assay for tumor microenvironment evaluation in melanoma tissues. Cancers (Basel). 2022;14(15):3682. doi: 10.3390/cancers14153682
  12. Papadas A, Deb G, Cicala A, Officer A, Hope C, Pagenkopf A, et al. Stromal remodeling regulates dendritic cell abundance and activity in the tumor microenvironment. Cell Rep. 2022;40(7):111257. doi: 10.1016/j.celrep.2022.111257
  13. Tzoras E, Zerdes I, Tsiknakis N, Manikis GC, Mezheyeuski A, Bergh J, et al. Dissecting tumor-immune microenvironment in breast cancer at a spatial and multiplex resolution. Cancers (Basel). 2022;14(8):1999. doi: 10.3390/cancers14081999
  14. Murphy KJ, Chambers CR, Herrmann D, Timpson P, Pereira BA. Dynamic stromal alterations influence tumor-stroma crosstalk to promote pancreatic cancer and treatment resistance. Cancers (Basel). 2021;13(14):3481. doi: 10.3390/cancers13143481
  15. Ahmed A, Klotz R, Köhler S, Giese N, Hackert T, Springfeld C, et al. Immune features of the peritumoral stroma in pancreatic ductal adenocarcinoma. Front Immunol. 2022;13:947407. doi: 10.3389/fimmu.2022.947407
  16. Saliba E, Bhawan J. Aberrant expression of immunohistochemical markers in malignant melanoma: a review. Dermatopathology (Basel). 2021;8(3):359–370. doi: 10.3390/dermatopathology8030040
  17. Weissinger SE, Keil P, Silvers DN, Klaus BM, Möller P, Horst BA, et al. A diagnostic algorithm to distinguish desmoplastic from spindle cell melanoma. Mod Pathol. 2014;27(4):524–534. doi: 10.1038/modpathol.2013.162
  18. Hughes TM, Williams GJ, Gyorki DE, Kelly JW, Stretch JR, Varey AHR, et al. Desmoplastic melanoma: a review of its pathology and clinical behaviour, and of management recommendations in published guidelines. J Eur Acad Dermatol Venereol. 2021;35(6):1290–1298. doi: 10.1111/jdv.17154
  19. Rawson RV, Vergara IA, Stretch JR, Saw RPM, Thompson JF, Lo SN, et al. Representativeness of initial skin biopsies showing pure desmoplastic melanoma: implications for management. Pathology. 2023;55(2):214–222. doi: 10.1016/j.pathol.2022.12.346
  20. Jin X, Zhou YF, Ma D, Zhao S, Lin CJ, Xiao Y, et al. Molecular classification of hormone receptor-positive HER2-negative breast cancer. Nat Genet. 2023;55(10):1696-1708. doi: 10.1038/s41588-023-01507-7
  21. Jain PV, Molina M, Moh M, Bishop E, Rader JS, Jorns JM. Immunohistochemistry in the differential diagnosis of triple negative breast carcinoma and high-grade serous carcinoma: old and new markers. Appl Immunohistochem Mol Morphol. 2024;32(10):456–461. doi: 10.1097/PAI.0000000000001232

Supplementary files

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2. Fig. 1. Desmoplastic melanoma: a flesh-colored or pink tumor with superficial epidermal thinning and erosion, featuring areas of gray-blue pigmentation

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3. Fig. 2. Dermatoscopic examination of desmoplastic melanoma: scarred areas and polymorphic vessels

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4. Fig. 3. Desmoplastic melanoma (microscopic examination, ×100, H&E staining). Multidirectional bundles of basophilic tumor cells within the papillary layer of the reticular dermis

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5. Fig. 4. Desmoplastic melanoma (microscopic examination, ×200, H&E staining). Expressed widespread invasion of the skin appendages

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6. Fig. 5. Desmoplastic melanoma (microscopic examination, × 400, H&E staining). Perineural invasion

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7. Fig. 6. Desmoplastic melanoma (immunohistochemical examination, × 200, test with anti-S100 and Melan A antibodies). Diffuse positive staining of tumor cells in anti-S100 test is observed. Melan A test only showed positive staining in the in situ melanoma component, while the desmoplastic melanoma cells were negative.

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8. Fig. 7. SOX 10. Diffuse nuclear staining, × 400

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Copyright (c) 2025 Makhachev D.R., Bulanov D.V., Shikhsaidova M.U., Magomedova M.N., Saipova K.A., Ibragimova D.I.

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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