Evolution of a melanoma in situ to a sarcomatoid dedifferentiated melanoma

Jina Chung, Alina Shevchenko, Jason B. Lee

Research output: Contribution to journalArticlepeer-review

Abstract

Sarcomatoid dedifferentiated melanoma (SDDM) is a recently recognized subtype of melanoma that stains diffusely for CD10 and lacks the expression of the usual melanocytic markers including S100, SOX10, MITF, and Melan A. Advances in next-generation DNA sequencing technology have facilitated the increased recognition of this rare, aggressive spindle cell melanoma. Herein, a case of relatively early lesion of SDDM arising in association with melanoma in situ is highlighted. A 72-year-old man with a history of previously treated melanoma in situ on the face five years prior presented with a new rapidly growing lesion within the scar of the treated site. A shave biopsy of the lesion revealed a centrally located 1.8-mm deep, poorly differentiated spindle cell neoplasm in association with an adjacent recurrent melanoma in situ. The spindle cell component stained diffusely for CD10, but failed to stain for S100, SOX10, and Melan-A while the melanoma in situ expressed all three melanocytic markers. Next-generation DNA sequencing assay revealed mutations in NF1, CDKN2A, TP53, and TSC1. A diagnosis of stage 2B SDDM arising in association with melanoma in situ was established based on the clinical context and genomic assay results.

Original languageEnglish (US)
Pages (from-to)943-947
Number of pages5
JournalJournal of cutaneous pathology
Volume48
Issue number7
DOIs
StatePublished - Jul 2021
Externally publishedYes

Keywords

  • CD10
  • atypical fibroxanthoma
  • next-generation sequence assay
  • sarcomatoid dedifferentiated melanoma
  • spindle cell melanoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology
  • Dermatology

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