Melanoma pathology reporting and staging. 

During Dermpath in 15 today, I mentioned a paper about how to handle Breslow thickness measurement of melanoma when there is a deeper focus around a sweat duct or hair follicle. This is the publication I was referring to: 

Dodds TJ, Lo S, Jackett L, Nieweg O, Thompson JF, Scolyer RA. Prognostic Significance of Periadnexal Extension in Cutaneous Melanoma and its Implications for Pathologic Reporting and Staging. Am J Surg Pathol. 2018 Mar;42(3):359-366. doi: 10.1097/PAS.0000000000000999. PMID: 29240580.

https://pubmed.ncbi.nlm.nih.gov/29240580/

Here's a quote from a later paper by Scolyer and colleagues summarizing the findings of the Dodds et al article. This paper is a gem! Full text free here: 

https://www.modernpathology.org/article/S0893-3952(22)00716-5/fulltext

"When there is deep periadnexal extension of melanoma as a “tongue” of tumor that extends much more deeply than the main, more superficial part of the dermal invasive melanoma, it is not recommended that such extension be included in the measurement of tumor thickness, unless this represents the only focus on invasion. Recently published data by Dodds et al. [29] provided evidence based on outcome data that periadnexal extension should not be included in tumor thickness measurements. When periadnexal melanoma represents the only focus of invasion, tumor thickness should be measured from the middle of the adnexal structure from where it has likely risen."

Quoted from: 

Scolyer RA, Rawson RV, Gershenwald JE, Ferguson PM, Prieto VG. Melanoma pathology reporting and staging. Mod Pathol. 2020 Jan;33(Suppl 1):15-24. doi: 10.1038/s41379-019-0402-x. Epub 2019 Nov 22. PMID: 31758078.