Nodular Melanoma (NM) and Lentigo Maligna Melanoma (LMM)

Nodular Melanoma(NM)

This type of melanoma is found in about 20% of cases. Nodular melanoma grows more aggressively, is more common in males. It tends to occur in middle age and likes to grow on the trunk, the neck and head. These lesions are sharply demarcated from the normal skin. They are raised and dome shaped because of a vertical growth pattern. The color is blue/black and resembles a blood blister. They are typically about 1 or 2 cm in diameter. Occasionally they grow like a cauliflower and about 5% are not pigmented, in which case they look flesh colored.

Lentigo Maligna Melanoma (LMM)

About 5% of melanoma cases present in this way. This melanoma is much more benign and tends to not metastasize. However, it can cause problems because of its size. It tends to grow on the face or neck of older white women. They are large lesions (see image), about 3 cm in diameter or bigger, typically tan colored, with different shades of brown. As the lesions enlarge, irregular mottling or flecking occurs with areas of dark brown or black.

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Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

1. Cancer: Principles &Practice of Oncology, 4th edition, by V.T. De Vita,Jr.,et. al J.B. LippincottCo.,Philadelphia, 1993.Vol.2: Chapter on Cutaneous melanoma.

2. The Merck Manual: Melanoma

3. Cancer: Principles&Practice of Oncology. 5th edition, volume 2. Edited by Vincent T. DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Chapter on Cutaneous melanoma.

4. SA Rosenberg et al. Ann Surg 1998 Sep 228(3): 307-319.

5. SA Rosenberg Nature 2001 May 17;411(6835):380-384.

6. T Todo et al. Proc Natl Acad Sci U S A 2001 May 15 ( page not available yet).

7. GJ Tsioulias et al. Ann Surg Oncol 2001 Apr;8(3):198-203.

Last Modified: Feb. 11, 2012