Original articleAn objective measure of growth rate using partial biopsy specimens of melanomas that were initially misdiagnosed
Section snippets
Methods
Institutional ethics board approval was obtained, and all patients involved provided written informed consent.
The Victorian Melanoma Service (VMS) is an Australian tertiary referral, multidisciplinary treatment center for melanoma. A retrospective review of the VMS database from January 1998 to January 2013 was performed to identify all primary melanomas in which pathologic misdiagnosis on the initial partial biopsy specimen caused a delay before excisional biopsy. All cases of initial
Results
Fifty-one melanomas satisfied the inclusion criteria. This represented 1.06% of the total number of melanoma cases that were referred to the VMS during the study period. The median age at diagnosis was 52 years (range, 15-86 years), and there was a female preponderance (32 females and 19 men). There were 23 superficial spreading melanomas (SSMs), 20 lentigo malignas (LMs)/lentigo maligna melanomas (LMMs), 4 desmoplastic melanomas (DMs), 2 acral lentiginous melanomas, and 2 uncategorized
Discussion
In this study, we identified 51 cases of initial melanoma misdiagnosis on partial biopsy specimens that caused a median delay of 27 months before referral and excisional biopsy. These unfortunate occurrences provided us with a unique insight into melanoma kinetics and a more objective quantification of growth rate to compare to the patient recall–based method. Because of uncertainty of the duration of the in situ phase, we favor the objective ROG derived from tumors that were invasive at the
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Funding sources: None.
Conflicts of interest: None declared.
Reprints not available from the authors.