Small-cell melanoma

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Small-cell melanoma

Small-cell melanoma on the skin

Small-cell melanoma is a rare and aggressive form of melanoma, a type of skin cancer that originates in the melanocytes, the cells responsible for producing melanin, the pigment that gives skin its color. This variant of melanoma is characterized by the presence of small, round, and densely packed tumor cells.

Pathophysiology

Small-cell melanoma is distinguished by its unique histological appearance. The tumor cells are small, with scant cytoplasm and hyperchromatic nuclei. This form of melanoma can be challenging to diagnose due to its resemblance to other small-cell neoplasms, such as small-cell lung cancer. Immunohistochemical staining is often required to confirm the diagnosis, with markers such as S-100 protein, HMB-45, and Melan-A being positive in melanoma cells.

Clinical Presentation

Patients with small-cell melanoma may present with a variety of symptoms depending on the location and stage of the tumor. Commonly, it appears as a new or changing pigmented lesion on the skin. Due to its aggressive nature, small-cell melanoma can metastasize rapidly to other parts of the body, including the lymph nodes, lungs, liver, and brain.

Diagnosis

The diagnosis of small-cell melanoma involves a combination of clinical examination, dermoscopy, and histopathological analysis. A biopsy of the suspicious lesion is essential for definitive diagnosis. Pathologists look for the characteristic small-cell morphology and use immunohistochemical stains to differentiate it from other small-cell malignancies.

Treatment

Treatment options for small-cell melanoma are similar to those for other types of melanoma and may include surgical excision, immunotherapy, targeted therapy, and chemotherapy. The choice of treatment depends on the stage of the disease and the overall health of the patient. Early detection and treatment are crucial for improving the prognosis.

Prognosis

The prognosis for small-cell melanoma is generally poor due to its aggressive nature and tendency to metastasize early. The survival rate is lower compared to other forms of melanoma, emphasizing the importance of early detection and intervention.

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Contributors: Prab R. Tumpati, MD