Table 3.
Pathways for melanomas that are not consistently associated with cumulative solar damage.
| Melanomas Not Consistently Associated with Cumulative Solar Damage | |||||
|---|---|---|---|---|---|
| Pathway |
IV Spitz melanoma |
V Acral melanoma |
VI Mucosal melanoma |
VII Melanomas arising in congenital nevi |
VIII Melanomas arising in blue nevi |
|
Benign
neoplasms (nevi) |
Spitz nevus | Acral nevus (?) | Melanosis (?) | Congenital nevus | Blue nevus |
|
Intermediate neoplasms (low-grade dysplasias and melanocytomas) |
Atypica Spitz tumor melanocytoma) | IAMPUS/dysplasia | Atypical melanosis /dysplasia/IAMPUS |
Nodul in congenital nevus (melanocytoma) | (Atypical) cellular blue nevus (melanocytoma) |
|
Intermediate neoplasms (high -grade dysplasias and melanocytomas) |
STUMP/ MELTUMP | Acral MIS | Mucosal MIS | MIS in congenital nevus | Atypical cellular blue nevus |
| Malignant neoplasms | Malignant Spitz tumor/Spitz melanoma (tumorigenic) | Acral melanoma (VGP) | Mucosal lentiginous melanoma (VGP) |
Melanoma in congenital nevus (tumorigenic) |
Melanoma in blue nevus (tumorigenic) |
| Common mutations | HRAS b; ALK e; ROS1 e; RET e; NTRK1 e; NTRK3 e; BRAF e; MET e; CDKN2A a | KIT b; NRAS b; BRAF b; HRAS b; KRAS b; NTRK3 e; ALK e; NF1 a; CDKN2A a; TERT f; CCND1 d; GAB2 d | KIT b; NRAS b; KRAS b; BRAF b; NF1 b; CDKN2A a; SF3B1 a; CCND1 d; CDK4 d; MDM2 d |
NRAS b; BRAF p.V600E b (small lesions); BRAF e | GNAQ b; GNA11 b; CYSLTR2 b; BAP1 a; EIF1AX c; SF3B1c |
Abbreviations: IAMPUS, intraepidermal atypical melanocytic proliferation of uncertain malignant potential; MELTUMP, melanocytic tumor of uncertain malignant potential; MIS, melanoma in situ; STUMP, spizoid tumor of uncertain malignant potential; VGP, vertical growth phase (tumorigenic and/or mitogenic melanoma). a Loss-of-function mutation; b gain-of-function mutation; c change-of-function mutation; d amplification; e rearrangement; f promoter mutation. (?) probable pathological type.