VARIANTS OF MELANOMA

The current classification of malignant melanomas gives recognition to superficial spreading melanoma, lentigo maligna melanoma, acral lenti ginous melanoma, and nodular types, In addition, neurotropic and desmo plastic types are recognized, The relativity inherent in the diagnosis of melanoma, provides the basis for the classification of melanomas o n the basis of size, Lesions measuring 1 mm or less in vertical dimens ions are unlikely to metastasize; they qualify as borderline melanocyt ic neoplasia of indeterminant malignant potential, The current classif ication has little relevancy to the category of variant nevi with the exceptions of malignant cellular blue nevus and melanoma arising in gi ant congenital nevi. A classification of variant melanomas as related to variant nevi is proposed, From a different perspective, a classific ation of melanomas with attention to nesting and cytological patterns in vertical growth is proposed: this alternate approach gives recognit ion to lesions that might otherwise be classified as ''nevoid'' melano mas, It also provides a default category for lesions that might otherw ise be assigned to the Spitz nevus like category, All of these tools f or the manipulation of the real and vidual images of melanomas have be en emphasized in the concept of minimal deviation melanoma. Copyright (C) 1997 by W.B. Saunders Company.