Pigmented Epithelioid Melanocytomas and Their Mimics; Focus on Their Novel Molecular Findings

Unraveling Complexity: Delving into a Novel Pigmented Epithelioid Melanocytoma Case

Pigmented epithelioid melanocytoma (PEM) is a rare and diagnostically challenging skin neoplasm. Differentiating this lesion from melanoma is challenging due to overlapping clinical, histopathological, and immunohistochemical features. Some PEMs have a benign course, while others may be associated with more aggressive behaviour and have potential for local recurrence or distant metastasis. So, careful evaluation and follow-up are crucial for individuals with a diagnosis of PEM. This case study focuses on a 42-year-old woman with a gradually enlarging, dark, pigmented gluteal lesion. Histopathological analysis following complete excision showed nodular proliferation of spindled and epithelioid melanocytes in the dermis, extending into subcutaneous fat. Cellular atypia or mitotic figures were absent, confirming the diagnosis as PEM. This case underscores the intricate balance between monitoring and intervention in complex dermatological cases, shedding light on diagnostic challenges and ultimately striving for improved patient care.

Nevi and Melanoma in Children: What to Do in Daily Medical Practice: Encyclopedia for Pediatricians and Family Doctors

Melanocytic nevi, commonly known as moles, are benign skin lesions that often occur in children and adolescents. Overall, they are less common in children compared to adults. Understanding the diagnosis and management of melanocytic nevi and risk factors for melanoma development is crucial for their early detection and appropriate treatment. This paper presents children's most common melanocytic nevi, including their epidemiology, morphology, diagnostic methods, and treatment.

Malignant Melanoma: An Overview, New Perspectives, and Vitamin D Signaling

Melanoma, originating through malignant transformation of melanin-producing melanocytes, is a formidable malignancy, characterized by local invasiveness, recurrence, early metastasis, resistance to therapy, and a high mortality rate. This review discusses etiologic and risk factors for melanoma, diagnostic and prognostic tools, including recent advances in molecular biology, omics, and bioinformatics, and provides an overview of its therapy. Since the incidence of melanoma is rising and mortality remains unacceptably high, we discuss its inherent properties, including melanogenesis, that make this disease resilient to treatment and propose to use AI to solve the above complex and multidimensional problems. We provide an overview on vitamin D and its anticancerogenic properties, and report recent advances in this field that can provide solutions for the prevention and/or therapy of melanoma. Experimental papers and clinicopathological studies on the role of vitamin D status and signaling pathways initiated by its active metabolites in melanoma prognosis and therapy are reviewed. We conclude that vitamin D signaling, defined by specific nuclear receptors and selective activation by specific vitamin D hydroxyderivatives, can provide a benefit for new or existing therapeutic approaches. We propose to target vitamin D signaling with the use of computational biology and AI tools to provide a solution to the melanoma problem.

The Spectrum of Spitz Melanocytic Lesions: From Morphologic Diagnosis to Molecular Classification

Spitz tumors represent a distinct subtype of melanocytic lesions with characteristic histopathologic features, some of which are overlapping with melanoma. More common in the pediatric and younger population, they can be clinically suspected by recognizing specific patterns on dermatoscopic examination, and several subtypes have been described. We now classify these lesions into benign Spitz nevi, intermediate lesions identified as “atypical Spitz tumors” (or Spitz melanocytoma) and malignant Spitz melanoma. More recently a large body of work has uncovered the molecular underpinning of Spitz tumors, including mutations in the HRAS gene and several gene fusions involving several protein kinases. Here we present an overarching view of our current knowledge and understanding of Spitz tumors, detailing clinical, histopathological and molecular features characteristic of these lesions.