Case 21 Male, 82 years. Ulcerating nodule, skin of chestShow diagnosis & comments
Spindle-cell melanoma, probably superficial spreading melanoma with partial regression and nodular outgrowth
Melanomas of any subtype may show spindle-shaped melanoma cells. This does not change the diagnosis or affect prognosis. Lentigo maligna melanoma more commonly shows spindled tumpour cells than most other melanoma subtypes, and desmoplastic melanoma is always spindle-celled.
This melanoma is associated with a stretch of adjacent superficial dermal fibrosis (most apparent in the top cross section that at first sight appears normal, uninvolved skin), that in all likelihood represents an area of partial regression of this melanoma. Because it reaches the excisional edge, this melanoma is incompletely excised. Partical regression is prognostically unfavourable in thin melanoma, but does not have an impact on the prognosis of thicker melanomas.