Tumoral melanosis
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Synopsis
Tumoral melanosis is usually observed from completely regressed melanocytic proliferations, including a primary malignant melanoma. In these cases, it may appear at the site of the primary tumor or at sites of cutaneous metastases, and the phenomenon is often associated with the presence of metastatic melanoma. Most recently, melanoma-associated tumoral melanosis has been described in patients with metastatic melanoma undergoing immunotherapy, such as with talimogene laherparepvec, ipilimumab, nivolumab, and pembrolizumab, as well as dabrafenib and trametinib. In these patients, tumoral melanosis usually occurs nearby the primary melanoma excision site or at the site of prior in-transit metastases.
Tumoral melanosis has also rarely been observed after regression of pigmented epithelial lesions, such as pigmented basal cell carcinoma, pigmented Bowen disease, seborrheic keratosis, solar lentigines, pigmented epithelial lined cysts, and benign nevi. Other pathologies described in the literature associated with this finding include mycosis fungoides and blastic plasmacytoid dendritic cell neoplasm (BPDCN).
Even more rarely, tumoral melanosis has been reported in the lymph nodes, known as nodal melanosis. Anecdotally, it has also been found in the visceral organs of 2 patients.
Codes
L81.4 – Other melanin hyperpigmentation
SNOMEDCT:
402612007 – Hypermelanosis due to neoplasia
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Last Updated:03/09/2023