However, wide local excision of a melanocytoma
site as for a melanoma may be unnecessary if the lesion involves a cosmetically sensitive area, such as the face; there is no evidence documenting the utility of such an approach.
Recent research illustrated that a small subset of melanocytic proliferations, most notably pigmented epithelioid melanocytoma
and atypical Spitz tumor, can spread to regional lymph nodes but in contrast to conventional melanoma only rarely metastasize to distant sites.
In view of the results of a clinicopathologic analysis of 40 patients with tumors previously diagnosed as "animal-type or pigment-synthesizing melanoma" or "epithelioid blue nevus," Zembowicz et al (101) proposed the term pigmented epithelioid melanocytoma
(PEM) to encompass these melanocytic tumors.
Primary intracranial pigmented neoplasms are rare and include melanoma, melanocytoma
, melanotic ependymoma, and subependymoma; pigmented choroid plexus papilloma and carcinoma[2-5]; and melanotic astrocytoma.
14] The nonneuroepithelial pigmented intracranial tumors reported in the literature are schwannoma, meningioma, melanoma, and melanocytoma
Bone and dura, right Favor malignant parietal region melanoma; melanocytoma
should also be included in differential diagnosis.
Namkoong S, Kim JY, Gye J et al: Pigmented epithelioid melanocytoma
developed in a patient with Becker nevus syndrome.
Some areas covered include acquired melanocytic nevi, congenital nevi and tumefactions, blue nevi and variants, combined nevi, pigmented epithelioid melanocytoma
, tumorigenic melanomas of WHO classification categories, neutrotropic melanoma, metastastic melanoma, and nonmelanocytic melanoma simulants.
14) These cells can be precursors to malignant melanoma, melanocytoma
, pigmented schwannoma, and pigmented medulloblastoma.
Pigmented lesions of the leptomeninges includes pigmented meningioma, metastatic malignant melanoma, primary malignant melanoma, meningeal melanocytoma
, melanotic schwannoma, and melanoblastosis.
In their opinion, the category of melanocytoma
is an intermediate category, which would represent a biologically gray area; it includes some problematic lesions, such as epithelioid pigmented melanocytoma
/animal type melanoma, atypical Spitz tumors, and atypical deep penetrating nevus, considered as MBITs.
I am not a dermatopathologist and will not weigh in on the diagnostic issues raised by Zembowicz and Scolyer (1) in their article in the March 2011 issue of Archives of Pathology & Laboratory Medicine, but their proposal to create a classification of melanocytoma
for a primary, cutaneous melanocytic lesion of "intermediate malignant potential" is another step toward nosologic confusion.