Desmoplastic Melanoma: Signs, Origins, and Healing Methods
Desmoplastic melanoma, a rare and unique form of skin cancer, requires a tailored approach for diagnosis and treatment. This subtype of melanoma is more common in individuals over the age of 60, people with light skin tones, and males than females [1].
The disease often presents with unusual symptoms, such as patches of thickened skin that resemble scars, growths that are pink or the same tone as a person's skin, and growths that are 6 millimeters or more in size [1]. These patches are primarily found on the head and neck.
When it comes to managing desmoplastic melanoma, the primary treatment is wide surgical excision to remove the primary tumor with adequate margins, reducing the risk of local recurrence [2]. In certain head and neck cases, Mohs micrographic surgery may be considered for tissue preservation and margin control, although its role is more established in squamous cell carcinomas [2].
Following surgery, adjuvant radiation therapy (RT) is often recommended, especially when margins are positive, the tumor is large, or if there is perineural invasion. This is due to the higher risk of local recurrence that desmoplastic melanoma can present, even after surgery [2].
In advanced stages, immunotherapy, such as checkpoint inhibitors, has become a valuable treatment option. Some studies have shown improvement and complete recovery in participants [3]. Immunotherapy may also be used as adjuvant therapy post-surgery to reduce recurrence risk.
Sentinel lymph node biopsy (SLNB) helps stage melanoma and guide adjuvant therapy decisions, but its utility may be less frequent in desmoplastic melanoma due to its unique pattern of spread. Ongoing advances improve risk stratification for SLNB recommendation [5].
Early diagnosis and treatment are crucial for increasing a person's chance of recovery. Given that only 27% of desmoplastic melanoma cases are accurately diagnosed after an initial examination, individuals who may be at risk should consider attending regular skin cancer screenings [4].
While the overall 5-year survival rate for desmoplastic melanoma is 75%, there is a lack of comprehensive data about this condition. Some people with desmoplastic melanoma may also experience symptoms such as bleeding, itching, or stinging [1].
In some cases, radiotherapy may be an additional treatment option. The use of gene-replacement therapy may also be considered for individuals with known genetic mutations associated with desmoplastic melanoma [1]. Due to the presence of mutations in multiple genes in many individuals with desmoplastic melanoma, combination therapy may be a better option for many [6].
In conclusion, the management of desmoplastic melanoma primarily involves wide surgical excision combined with adjuvant radiation to improve local control. Immunotherapy may be added depending on disease stage and risk factors. Sentinel lymph node biopsy is generally utilized for staging but with specific considerations in this subtype. Regular skin cancer screenings are strongly recommended for individuals at risk.
[1] American Cancer Society. (2021). Desmoplastic Melanoma. [2] National Comprehensive Cancer Network. (2021). Desmoplastic Melanoma. [3] American Society of Clinical Oncology. (2021). Immunotherapy for Melanoma. [4] Skin Cancer Foundation. (2021). Desmoplastic Melanoma. [5] Mayo Clinic. (2021). Sentinel lymph node biopsy. [6] Cancer Research UK. (2021). Targeted cancer treatments.
- A tailored approach is necessary for the diagnosis and treatment of desmoplastic melanoma, a unique form of skin cancer that is more common in older adults, individuals with light skin tones, and males.
- Immunotherapy, such as checkpoint inhibitors, has become a valuable treatment option in advanced stages of desmoplastic melanoma, offering improvement and complete recovery in some cases.
- The lack of comprehensive data about desmoplastic melanoma emphasizes the importance of regular skin cancer screenings, especially for individuals who may be at risk, as only 27% of cases are accurately diagnosed after an initial examination.
