Follicular Malignant Melanoma: A Rare Morphologic Variant of Melanoma. Report of a Case and Review of the Literature

Follicular malignant melanoma (FMM) is an exceedingly rare variant of melanoma. Only 8 cases have been reported in the literature thus far. Often bland on physical examination, FMM shows a striking histologic pattern, with atypical melanocytes sometimes consuming the entire follicle and extending in...

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Bibliographic Details
Published inThe American journal of dermatopathology Vol. 39; no. 5; p. e69
Main Authors Chapman, Iona, Horton, Sharon, Liu, Wenhua
Format Journal Article
LanguageEnglish
Published United States 01.05.2017
Subjects
Adenoma - pathology
Adenoma - surgery
Biopsy, Needle
Dermatologic Surgical Procedures - methods
Follow-Up Studies
Humans
Immunohistochemistry
Male
Melanoma - pathology
Melanoma - surgery
Melanoma, Cutaneous Malignant
Middle Aged
Rare Diseases
Risk Assessment
Sentinel Lymph Node Biopsy - methods
Skin Neoplasms - pathology
Skin Neoplasms - surgery
Treatment Outcome
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Summary:Follicular malignant melanoma (FMM) is an exceedingly rare variant of melanoma. Only 8 cases have been reported in the literature thus far. Often bland on physical examination, FMM shows a striking histologic pattern, with atypical melanocytes sometimes consuming the entire follicle and extending into the dermis. Criteria have been suggested to help distinguish FMM from lentigo maligna melanoma; however, no clear criteria distinguish this cancer clinically. FMM cannot be distinguished from follicular metastases of melanoma based on histology, requiring close clinical correlation and detailed history taking on the part of the practitioner. In this publication, we present a case of FMM and a review of the literature. A 59-year-old man was incidentally found to have a small flesh-colored papule on the arm during a skin cancer screening. Biopsy revealed atypical melanocytes extending from the follicular infundibulum into the reticular dermis. Immunohistochemical staining confirmed the melanocytic origin of the neoplasm. The patient underwent wide local excision with 2-cm margins. Sentinel lymph node biopsy was negative for melanoma. We present this case to highlight an unusual type of melanoma and illustrate how it may be distinguished from other neoplasms.
ISSN:1533-0311
DOI:10.1097/dad.0000000000000799