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WHO Classification of Tumours
Nodular melanoma
Skin


Definition

Nodular melanoma (NM) is an aggressive form of malignant melanoma , presenting as a rapidly expanding, papular or nodular raised skin lesion and exhibiting exclusively vertical growth. It may arise in any location but shows a predilection for the trunk, head and neck, and lower legs. The tumours are usually well delineated. The skin margins are frequently obliterated by ulceration and crust.
Histologically, nodular melanoma is characterized by a cohesive nodule or small nests of typically epithelioid tumour cells in the dermis. The growth pattern is pushing or expansile. Mononuclear cell infiltrates, fibroplasia, telangiectasia, and melanophages may be found in the surrounding stroma.
Nodular melanoma accounts for 10-15% of all melanomas in Caucasians. The most important prognostic factors are tumour thickness, increased mitotic rate and ulceration. Nodular melanoma spreads first to the local lymph nodes and then to internal organs. Nonvisceral metastases are associated with a better prognosis than visceral metastases

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LeBoit PE, Burg G, Weedon D, Sarasin A (Eds.)
World Health Organization Classification of Tumours. Pathology and Genetics of Skin Tumours
3rd Edition
IARC Press: Lyon 2005



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