TABLE 3.

Available Literature Evaluating Outcomes of Atypical Melanocytic Lesions

Study	Study Design	Diagnosis	No. of Patients	Median Follow-Up (mo)	Outcome
Abraham and colleagues11	Retrospective cross-sectional study	MELTUMP	32	111	2 patients died of melanoma-related disease; 25% of patients had lymphatic invasion
Berk and colleagues126	Retrospective cross-sectional study	Melanoma, MELTUMP	13 (melanoma) 7 (MELTUMP)	27 (melanoma) 22 (MELTUMP)	Positive SLN in 20% of patients with melanoma and 33% of patients with MELTUMP; emphasis on the need for close follow-up in patients with MELTUMP
Cerroni and colleagues67	Tutorial held at XXIX Symposium of the International Society of Dermatopathology	MELTUMP	57	NR	MELTUMPs as a group exist and may be biologically different from conventional melanoma and benign melanocytic nevi; terminology is highly controversial; there is uncertainty in classification and interpretation
Cunningham and colleagues116	Retrospective cross-sectional study	MELTUMP	27	22.8	44% of lesions were graded as melanoma Stage 1A or 1B; 4% of these lesions were upstaged to Stage 1B after excision
El Tal and colleagues53	Retrospective cross-sectional study	AJMH	27	24–72	Most common location was lower extremity; no recurrences observed
Green and colleagues109	Retrospective cross-sectional study	MELTUMP	42	23	1 patient developed locally recurrent disease; 1 patient developed regional metastases; and 1 patient died of metastatic disease
Jessup and Cohen25	Retrospective cross-sectional study	DNIEMD	263	NR	71% of lesions were found on the lower extremities; 24% of patients had a personal history of melanoma
Kaltoft and colleagues52	Retrospective cross-sectional study	MELTUMP	67	NR	6% of patients had regional nodal dissemination at the time of diagnosis; 1 patient developed regional spread at follow-up; and 1 patient died of distant metastases 1 yr after diagnosis
Magro and colleagues17	Prospective cohort study	Dermal BMT	32	50	34% of patients had positive SLN; 3% of patients died of metastatic disease
Meyers and colleagues125	Retrospective cross-sectional study	MELTUMP	31	16	16% of patients had positive SLN; younger age and greater Breslow depth were associated with a positive SLN
Mills and colleagues7	Retrospective cross-sectional study	Atypical melanocytic proliferation	24	49	29% of patients had positive SLN; no recurrences at median follow-up
Okamura and colleagues26	Retrospective cross-sectional study	AJMH	400	6–24	6.2% of cases exhibited benign AJMH; 40% of these lesions were located on the face; no patients developed melanoma
Phillips and colleagues39	Retrospective cross-sectional study	MDM	21	57	2 patients died of widespread metastatic disease
Pusiol and colleagues46	Retrospective cross-sectional study	MELTUMP	14	>36	1 patient with positive SLN; all patients free of disease at follow-up
Sachdeva and colleagues24	Retrospective cross-sectional study	DNIEMD	82	NR	55% of patients had atypical mole phenotype; 27% of patients had a previous or subsequent diagnosis of melanoma
Zhang and colleagues12	Retrospective cross-sectional study	AIMP	413	NR	2.9% of lesions had positive or equivocal margins after initial excision; increased risk of incomplete excision associated with location on the head and neck or a preoperative biopsy that includes MIS in the differential diagnosis
Zhang and colleagues13	Retrospective cross-sectional study	AIMP	306	NR	4.2% of lesions were upstaged to melanoma on review of excision specimen; risk factors for upstaging included location on head and neck or acral areas, lesion extension to base of biopsy specimen, use of punch biopsy technique, and melanoma in initial histopathologic differential diagnosis

AIMP, atypical intraepidermal melanocytic proliferation; AJMH, atypical junctional melanocytic hyperplasia; BMT, borderline melanocytic tumor; DNIEMD, de novo intraepidermal melanocytic dysplasia; MDM, minimal deviation melanoma; MELTUMP, melanocytic tumors of uncertain malignant potential; MIS, melanoma in situ; NR, not recorded; SLN, sentinel lymph node.