Melanocytes can give rise to a variety of benign and malignant neoplasms that are characterized by distinct clinical features, histopathological appearances, and biological behavior. In most melanocytic lesions, the clinical and histopathological distinction between benign (melanocytic nevus) and malignant (melanoma) is relatively easy. However, there exist unusual melanocytic neoplasms whose biological behavior can be difficult to predict with certainty owing to their ambiguous clinical and pathological features. This may lead to underdiagnosis or overdiagnosis of melanoma, or to diagnosis as “melanocytic tumor of uncertain malignant potential” or “melanocytic lesion with severe atypia.” The lack of agreement, even among experts, in determining the biological behavior of these lesions is well documented in the medical literature.1
Wiesner T. Genomic Rearrangements in Unusual and Atypical Melanocytic Neoplasms. JAMA Dermatol. 2016;152(3):260–262. doi:https://doi.org/10.1001/jamadermatol.2015.3501
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