Clinical Meaning
Cutaneous melanoma arises from malignant transformation of melanocytes, the pigment producing cells in the stratum basale of the epidermis.
Cutaneous melanoma arises from malignant transformation of melanocytes, the pigment-producing cells in the stratum basale of the epidermis. Melanoma accounts for only 4% of skin cancers but causes 80% of skin cancer deaths due to its aggressive metastatic potential. Melanoma subtypes include: superficial spreading melanoma (70% — most common, radial growth phase with lateral spread before vertical invasion), nodular melanoma (15% — most aggressive, lacks radial growth phase, presents as rapidly growing raised nodule with early vertical invasion), lentigo maligna melanoma (10% — arises on chronically sun-damaged skin in elderly, face/neck, slow progression from lentigo maligna in situ), and acral lentiginous melanoma (5% in Caucasians, most common subtype in darker-skinned individuals — palms, soles, nail beds; Bob Marley died of undiagnosed acral melanoma). Breslow depth is the SINGLE MOST IMPORTANT prognostic factor — it measures tumor thickness in millimeters from the granular layer of the epidermis to the deepest point of tumor invasion. The 2018 AJCC 8th edition staging uses Breslow depth thresholds: T1 (≤1.0 mm), T2 (1.01-2.0 mm), T3 (2.01-4.0 mm), T4 (>4.0 mm). Ulceration upstages the T classification...
