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Melanoma — SCE Dermatology MCQ

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HardSkin CancerMelanomaSCE Dermatology

A 45-year-old woman has been diagnosed with melanoma with microsatellites on histology. What are microsatellites and what is their prognostic significance?

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Correct answer: E — Microscopic nests of metastatic melanoma in dermis/subcutis separated from the primary tumour by normal tissue — adverse prognostic significance

Microsatellites are microscopic nests of metastatic melanoma (≥0.05 mm) in the dermis, subcutis, or lymphovascular spaces discontinuous from and separated from the primary tumour by normal tissue. They represent early local metastatic spread and are an adverse prognostic factor. In the AJCC 8th edition, microsatellites are classified as N1c (in the absence of lymph node metastases), automatically upstaging the patient to at least stage IIIB. This has important therapeutic implications as patients with microsatellites should be offered adjuvant systemic therapy. Microsatellites should be distinguished from regression and from the primary tumour's invasive front.

Reference: AJCC 2017 8th Edition; BAD 2017 Melanoma Guidelines