Nevus-Associated Melanomas: Clinicopathologic Features

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Data
2014-10-01
Autores
Shitara, Danielle [UNIFESP]
Nascimento, Mauricio M. [UNIFESP]
Puig, Susana
Yamada, Sergio [UNIFESP]
Enokihara, Milvia M. S. S. [UNIFESP]
Michalany, Nilceo [UNIFESP]
Bagatin, Edileia [UNIFESP]
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Objectives: the clinical significance of nevus-associated melanoma compared with de novo melanomas remains controversial. It has been suggested that nevus-associated melanomas have a higher Breslow thickness and therefore worse prognosis. Over a 10-year period, this study evaluated the incidence of nevus-associated melanoma and its prognostic significance related to clinicopathologic features.Methods: Cross-sectional study from 1995 through 2004 in a dermatopathology referral center. With available data, we evaluated sex, primary location, histologic subtype, Breslow thickness, Clark level, presence of ulceration, associated lesion, and histologic subtype of the associated lesion.Results: of 135,653 pathologic records from skin biopsy specimens over a 10-year period, 1,190 melanoma records were selected Nevus-associated melanomas corresponded to 390 (32.8%) melanomas, with thin melanomas having a nevus 1.52 times the association observed with thick melanomas (>1.01 mm; 95% confidence interval, 1.16-1.99; P <.001). Superficial spreading melanoma was the most frequent, while no lentigo maligna melanoma was associated with nevi. the median Breslow thickness of nevus-associated melanomas was lower than that of de novo melanomas.Conclusions: Nevus-associated melanomas, which represent one-third of the melanomas in southeast Brazil, are associated with intermittent sun exposure, superficial spreading melanomas, and lower Breslow thickness. This is one of the largest series describing nevus-associated melanomas in Latin America.
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American Journal of Clinical Pathology. Chicago: Amer Soc Clinical Pathology, v. 142, n. 4, p. 485-491, 2014.