Skip to main content
SpringerLink
Log in
Book cover

Immunotherapy of Melanoma pp 21–47Cite as

Melanoma—Diagnosis, Subtypes and AJCC Stages

  • Chapter
  • First Online:

  • 1036 Accesses

Abstract

Unlike several other types of cancer, melanoma can be easily detected in its earliest stages; sometimes they are also detected by the patients themselves as abnormal pigmented spots on the skin. Clinical features of melanoma that helps in the diagnosis, subtypes of melanoma and different types of approaches used to classify the progression of melanoma are discussed in this chapter. The characteristic features of melanoma such as Asymmetric shape, irregular Border, variegated Color, large Diameter and Evolving nature of the lesions (described by the acronym ABCDE) are explained in the beginning of the chapter. Various methods that help in the diagnosis of melanoma are then described in the chapter with emphasis on significance of dermoscopy, histopathology and molecular biomarkers such as S100 in the diagnosis of melanoma. In addition, other newly introduced diagnostic aids like total body photography and in vivo reflectance confocal laser microscopy are also discussed in the chapter. Next, different variants of melanoma such as superficially spreading melanoma, lentigo maligna, acral lentiginous melanoma, nodular melanoma, desmoplastic melanoma, nevoid melanoma and verrucous melanoma are discussed with details on clinical, dermoscopic and histological features, overall incidence, correlation with patient characteristics such as age, gender and location of lesion and comparison with overall melanoma prognosis. Finally, various classification methods developed to determine the stage of melanoma progression are discussed; classifications using Clark’s Level of invasion, Breslow thickness, Tumor, Node and Metastasis (TNM) as well as the system developed by AJCC are discussed in detail towards the end of the chapter.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Chamberlain, A., & Ng, J. (2009). Cutaneous melanoma–atypical variants and presentations. Australian Family Physician, 38(7), 476–482.

    PubMed  Google Scholar 

  2. Schadendorf, D., Fisher, D. E., Garbe, C., Gershenwald, J. E., Grob, J., Halpern, A., et al. (2015). Melanoma. Nature Reviews Disease Primers, doi:10.1038/nrdp.2015.3

  3. Brady, M. S., Oliveria, S. A., Christos, P. J., Berwick, M., Coit, D. G., Katz, J., et al. (2000). Patterns of detection in patients with cutaneous melanoma. Cancer, 89(2), 342–347. doi:10.1002/1097-0142(20000715)89:2<342::AID-CNCR19>3.0.CO;2-P [pii].

  4. McPherson, M., Elwood, M., English, D. R., Baade, P. D., Youl, P. H., & Aitken, J. F. (2006). Presentation and detection of invasive melanoma in a high-risk population. Journal of the American Academy of Dermatology, 54(5), 783–792. doi:10.1016/j.jaad.2005.08.065 S0190-9622(05)02597-1 [pii].

  5. Melanoma: Practice Essentials, Overview, Indications and Guidelines.

    Google Scholar 

  6. McCourt, C., Dolan, O., & Gormley, G. (2014). Malignant melanoma: A pictorial review. Ulster Medical Journal, 83(2), 103–110.

    PubMed  PubMed Central  Google Scholar 

  7. Arrangoiz, R., Dorantes, J., Cordera, F., Juarez, M. M., Paquentin, E. M., & L., d. L. E. (2016). Melanoma review: Epidemiology, Risk factors, diagnosis and staging. [Review]. Journal of Cancer Treatment and Research, 4(1), 1–15. doi:10.11648/j.jctr.20160401.11

    Google Scholar 

  8. Marghoob, A. A., & Scope, A. (2009). The complexity of diagnosing melanoma. Journal of Investigative Dermatology, 129(1), 11–13. doi:10.1038/jid.2008.388 jid2008388 [pii].

    Google Scholar 

  9. Kittler, H., Pehamberger, H., Wolff, K., & Binder, M. (2002). Diagnostic accuracy of dermoscopy. The Lancet Oncology, 3(3), 159–165. S1470204502006794 [pii].

    Google Scholar 

  10. Garbe, C., Peris, K., Hauschild, A., Saiag, P., Middleton, M., Spatz, A., et al. (2012). Diagnosis and treatment of melanoma. European consensus-based interdisciplinary guideline--Update 2012. European Journal of Cancer, 48(15), 2375–2390. doi:10.1016/j.ejca.2012.06.013 S0959-8049(12)00516-3 [pii].

  11. Carli, P., De Giorgi, V., Chiarugi, A., Nardini, P., Weinstock, M. A., Crocetti, E., et al. (2004). Addition of dermoscopy to conventional naked-eye examination in melanoma screening: A randomized study. Journal of the American Academy of Dermatology, 50(5), 683–689. doi:10.1016/j.jaad.2003.09.009 S0190962203033140 [pii].

  12. Carli, P., De Giorgi, V., Crocetti, E., Mannone, F., Massi, D., Chiarugi, A., et al. (2004). Improvement of malignant/benign ratio in excised melanocytic lesions in the ‘dermoscopy era’: A retrospective study 1997–2001. British Journal of Dermatology, 150(4), 687–692. doi:10.1111/j.0007-0963.2004.05860.x BJD5860 [pii].

  13. Vestergaard, M. E., Macaskill, P., Holt, P. E., & Menzies, S. W. (2008). Dermoscopy compared with naked eye examination for the diagnosis of primary melanoma: A meta-analysis of studies performed in a clinical setting. British Journal of Dermatology, 159(3), 669–676. doi:10.1111/j.1365-2133.2008.08713.x BJD8713 [pii].

  14. Kittler, H., Guitera, P., Riedl, E., Avramidis, M., Teban, L., Fiebiger, M., et al. (2006). Identification of clinically featureless incipient melanoma using sequential dermoscopy imaging. Archives of Dermatology, 142(9), 1113–1119. doi:10.1001/archderm.142.9.1113 142/9/1113 [pii].

  15. Haenssle, H. A., Krueger, U., Vente, C., Thoms, K. M., Bertsch, H. P., Zutt, M., et al. (2006). Results from an observational trial: Digital epiluminescence microscopy follow-up of atypical nevi increases the sensitivity and the chance of success of conventional dermoscopy in detecting melanoma. Journal of Investigative Dermatology, 126(5), 980–985. doi:10.1038/sj.jid.5700119 5700119 [pii].

  16. Kelly, J. W., Yeatman, J. M., Regalia, C., Mason, G., & Henham, A. P. (1997). A high incidence of melanoma found in patients with multiple dysplastic naevi by photographic surveillance. Medical Journal of Australia, 167(4), 191–194.

    CAS  PubMed  Google Scholar 

  17. Rhodes, A. R. (1998). Intervention strategy to prevent lethal cutaneous melanoma: Use of dermatologic photography to aid surveillance of high-risk persons. Journal of the American Academy of Dermatology, 39(2 Pt 1), 262–267. S0190-9622(98)70086-6 [pii].

    Google Scholar 

  18. Feit, N. E., Dusza, S. W., & Marghoob, A. A. (2004). Melanomas detected with the aid of total cutaneous photography. British Journal of Dermatology, 150(4), 706–714. doi:10.1111/j.0007-0963.2004.05892.x BJD5892 [pii].

  19. Goodson, A. G., Florell, S. R., Hyde, M., Bowen, G. M., & Grossman, D. (2010). Comparative analysis of total body and dermatoscopic photographic monitoring of nevi in similar patient populations at risk for cutaneous melanoma. Dermatologic Surgery, 36(7), 1087–1098. doi:10.1111/j.1524-4725.2010.01589.x DSU1589 [pii].

  20. Salerni, G., Carrera, C., Lovatto, L., Puig-Butille, J. A., Badenas, C., Plana, E., et al. (2012). Benefits of total body photography and digital dermatoscopy (“two-step method of digital follow-up”) in the early diagnosis of melanoma in patients at high risk for melanoma. Journal of the American Academy of Dermatology, 67(1), e17–27. doi:10.1016/j.jaad.2011.04.008 S0190-9622(11)00476-2 [pii].

  21. Moloney, F. J., Guitera, P., Coates, E., Haass, N. K., Ho, K., Khoury, R., et al. (2014). Detection of primary melanoma in individuals at extreme high risk: A prospective 5-year follow-up study. JAMA Dermatology, 150(8), 819–827. doi:10.1001/jamadermatol.2014.514 1883732 [pii].

    Google Scholar 

  22. Calzavara-Pinton, P., Longo, C., Venturini, M., Sala, R., & Pellacani, G. (2008). Reflectance confocal microscopy for in vivo skin imaging. Photochemistry and Photobiology, 84(6), 1421–1430. doi:10.1111/j.1751-1097.2008.00443.x PHP443 [pii].

  23. Guitera, P., Pellacani, G., Longo, C., Seidenari, S., Avramidis, M., & Menzies, S. W. (2009). In vivo reflectance confocal microscopy enhances secondary evaluation of melanocytic lesions. Journal of Investigative Dermatology, 129(1), 131–138. doi:10.1038/jid.2008.193 jid2008193 [pii].

    Google Scholar 

  24. Pellacani, G., Pepe, P., Casari, A., & Longo, C. (2014). Reflectance confocal microscopy as a second-level examination in skin oncology improves diagnostic accuracy and saves unnecessary excisions: A longitudinal prospective study. British Journal of Dermatology, 171(5), 1044–1051. doi:10.1111/bjd.13148.

    Article  CAS  PubMed  Google Scholar 

  25. Monheit, G., Cognetta, A. B., Ferris, L., Rabinovitz, H., Gross, K., Martini, M., et al. (2011). The performance of MelaFind: A prospective multicenter study. Archives of Dermatology, 147(2), 188–194. doi:10.1001/archdermatol.2010.302 archdermatol.2010.302 [pii].

  26. Malvehy, J., Hauschild, A., Curiel-Lewandrowski, C., Mohr, P., Hofmann-Wellenhof, R., Motley, R., et al. (2014). Clinical performance of the Nevisense system in cutaneous melanoma detection: An international, multicentre, prospective and blinded clinical trial on efficacy and safety. British Journal of Dermatology, 171(5), 1099–1107. doi:10.1111/bjd.13121.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Ruiter, D. J., Spatz, A., van den Oord, J. J., & Cook, M. G. (2002). Pathologic staging of melanoma. Seminars in Oncology, 29(4), 370–3810. S0093775402502670 [pii].

    Google Scholar 

  28. Carlson, J. A., Slominski, A., Linette, G. P., Mihm, M. C., Jr., & Ross, J. S. (2003). Biomarkers in melanoma: Staging, prognosis and detection of early metastases. Expert Review of Molecular Diagnostics, 3(3), 303–330. doi:10.1586/14737159.3.3.303 ERM030305 [pii].

  29. Lodha, S., Saggar, S., Celebi, J. T., & Silvers, D. N. (2008). Discordance in the histopathologic diagnosis of difficult melanocytic neoplasms in the clinical setting. Journal of Cutaneous Pathology, 35(4), 349–352. doi:10.1111/j.1600-0560.2007.00970.x CUP970 [pii].

  30. Shoo, B. A., Sagebiel, R. W., & Kashani-Sabet, M. (2010). Discordance in the histopathologic diagnosis of melanoma at a melanoma referral center. Journal of the American Academy of Dermatology, 62(5), 751–756. doi:10.1016/j.jaad.2009.09.043 S0190-9622(09)01255-9 [pii].

  31. Ohsie, S. J., Sarantopoulos, G. P., Cochran, A. J., & Binder, S. W. (2008). Immunohistochemical characteristics of melanoma. Journal of Cutaneous Pathology, 35(5), 433–444. doi:10.1111/j.1600-0560.2007.00891.x CUP891 [pii].

  32. Jackel, A., Deichmann, M., Waldmann, V., Bock, M., & Naher, H. (1999). S-100 beta protein in serum, a tumor marker in malignant melanoma—current state of knowledge and clinical experience. Hautarzt, 50(4), 250–256.

    Article  CAS  PubMed  Google Scholar 

  33. Henze, G., Dummer, R., Joller-Jemelka, H. I., Boni, R., & Burg, G. (1997). Serum S100—a marker for disease monitoring in metastatic melanoma. Dermatology, 194(3), 208–212.

    Article  CAS  PubMed  Google Scholar 

  34. Bauer, J., & Bastian, B. C. (2006). Distinguishing melanocytic nevi from melanoma by DNA copy number changes: Comparative genomic hybridization as a research and diagnostic tool. Dermatology and Therapy, 19(1), 40–49. doi:10.1111/j.1529-8019.2005.00055.x DTH055 [pii].

  35. Gerami, P., Jewell, S. S., Morrison, L. E., Blondin, B., Schulz, J., Ruffalo, T., et al. (2009). Fluorescence in situ hybridization (FISH) as an ancillary diagnostic tool in the diagnosis of melanoma. American Journal of Surgical Pathology, 33(8), 1146–1156. doi:10.1097/PAS.0b013e3181a1ef36.

    Article  PubMed  Google Scholar 

  36. Colombino, M., Capone, M., Lissia, A., Cossu, A., Rubino, C., De Giorgi, V., et al. (2012). BRAF/NRAS mutation frequencies among primary tumors and metastases in patients with melanoma. Journal of Clinical Oncology, 30(20), 2522–2529. doi:10.1200/JCO.2011.41.2452 JCO.2011.41.2452 [pii].

  37. Johnson, D. B., & Puzanov, I. (2015). Treatment of NRAS-mutant melanoma. Current Treatment Options in Oncology, 16(4), 15. doi:10.1007/s11864-015-0330-z.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Hodi, F. S., Friedlander, P., Corless, C. L., Heinrich, M. C., Mac Rae, S., Kruse, A., et al. (2008). Major response to imatinib mesylate in KIT-mutated melanoma. Journal of Clinical Oncology, 26(12), 2046–2051. doi:10.1200/JCO.2007.14.0707 26/12/2046 [pii].

  39. Carvajal, R. D., Antonescu, C. R., Wolchok, J. D., Chapman, P. B., Roman, R. A., Teitcher, J., et al. (2011). KIT as a therapeutic target in metastatic melanoma. JAMA, 305(22), 2327–2334. doi:10.1001/jama.2011.746 305/22/2327 [pii].

    Google Scholar 

  40. Warycha, M. A., Christos, P. J., Mazumdar, M., Darvishian, F., Shapiro, R. L., Berman, R. S., et al. (2008). Changes in the presentation of nodular and superficial spreading melanomas over 35 years. Cancer, 113(12), 3341–3348. doi:10.1002/cncr.23955.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Greenwald, H. S., Friedman, E. B., & Osman, I. (2012). Superficial spreading and nodular melanoma are distinct biological entities: A challenge to the linear progression model. Melanoma Research, 22(1), 1–8. doi:10.1097/CMR.0b013e32834e6aa0.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Forman, S. B., Ferringer, T. C., Peckham, S. J., Dalton, S. R., Sasaki, G. T., Libow, L. F., et al. (2008). Is superficial spreading melanoma still the most common form of malignant melanoma? Journal of the American Academy of Dermatology, 58(6), 1013–1020. doi:10.1016/j.jaad.2007.10.650 S0190-9622(07)02421-8 [pii].

  43. Scolyer, R. A., Long, G. V., & Thompson, J. F. (2011). Evolving concepts in melanoma classification and their relevance to multidisciplinary melanoma patient care. Molecular Oncology, 5(2), 124–136. doi:10.1016/j.molonc.2011.03.002 S1574-7891(11)00029-9 [pii].

  44. Saldanha, G., Potter, L., Daforno, P., & Pringle, J. H. (2006). Cutaneous melanoma subtypes show different BRAF and NRAS mutation frequencies. Clinical Cancer Research, 12(15), 4499–4505, doi:10.1158/1078-0432.CCR-05-2447 12/15/4499 [pii].

  45. Sasaki, Y., Niu, C., Makino, R., Kudo, C., Sun, C., Watanabe, H., et al. (2004). BRAF point mutations in primary melanoma show different prevalences by subtype. Journal of Investigative Dermatology, 123(1), 177–183. doi:10.1111/j.0022-202X.2004.22722.x JID22722 [pii].

  46. Liu, W., Kelly, J. W., Trivett, M., Murray, W. K., Dowling, J. P., Wolfe, R., et al. (2007). Distinct clinical and pathological features are associated with the BRAF(T1799A(V600E)) mutation in primary melanoma. Journal of Investigative Dermatology, 127(4), 900–905. doi:10.1038/sj.jid.5700632 5700632 [pii].

  47. Broekaert, S. M., Roy, R., Okamoto, I., van den Oord, J., Bauer, J., Garbe, C., et al. (2010). Genetic and morphologic features for melanoma classification. Pigment Cell & Melanoma Research, 23(6), 763-770, doi:10.1111/j.1755-148X.2010.00778.x

    Google Scholar 

  48. Lee, J. H., Choi, J. W., & Kim, Y. S. (2011). Frequencies of BRAF and NRAS mutations are different in histological types and sites of origin of cutaneous melanoma: a meta-analysis. British Journal of Dermatology, 164(4), 776-784, doi:10.1111/j.1365-2133.2010.10185.x

    Google Scholar 

  49. Wolf, I. H., Cerroni, L., Kodama, K., & Kerl, H. (2005). Treatment of lentigo maligna (melanoma in situ) with the immune response modifier imiquimod. Archives of Dermatology, 141(4), 510–514. doi:10.1001/archderm.141.4.510141/4/510 [pii].

  50. Bradford, P. T., Goldstein, A. M., McMaster, M. L., & Tucker, M. A. (2009). Acral lentiginous melanoma: Incidence and survival patterns in the United States, 1986–2005. Archives of Dermatology, 145(4), 427–434. doi:10.1001/archdermatol.2008.609 145/4/427 [pii].

  51. Patel, K. A., & Ferraro, A. J. (2015). Acral lentiginous melanoma: A case and literature review. doi:10.3827/faoj.2015.0801.0001

  52. Pereda, C., Traves, V., Requena, C., Serra-Guillen, C., Llombart, B., Sanmartin, O., et al. (2013). Clinical presentation of acral lentiginous melanoma: A descriptive study. Actas Dermo-Sifiliográficas, 104(3), 220–226. doi:10.1016/j.ad.2012.06.006 S0001-7310(12)00301-8 [pii].

  53. Phan, A., Touzet, S., Dalle, S., Ronger-Savle, S., Balme, B., & Thomas, L. (2006). Acral lentiginous melanoma: A clinicoprognostic study of 126 cases. British Journal of Dermatology, 155(3), 561–569. doi:10.1111/j.1365-2133.2006.07368.x BJD7368 [pii].

  54. Saida, T., Miyazaki, A., Oguchi, S., Ishihara, Y., Yamazaki, Y., Murase, S., et al. (2004). Significance of dermoscopic patterns in detecting malignant melanoma on acral volar skin: Results of a multicenter study in Japan. Archives of Dermatology, 140(10), 1233–1238. doi:10.1001/archderm.140.10.1233 140/10/1233 [pii].

  55. Braun, R. P., Thomas, L., Kolm, I., French, L. E., & Marghoob, A. A. (2008). The furrow ink test: A clue for the dermoscopic diagnosis of acral melanoma vs nevus. Archives of Dermatology, 144(12), 1618–1620. doi:10.1001/archderm.144.12.1618 144/12/1618 [pii].

  56. Kelly, J. W., Chamberlain, A. J., Staples, M. P., & McAvoy, B. (2003). Nodular melanoma. No longer as simple as ABC. Australian Family Physician, 32(9), 706–709.

    PubMed  Google Scholar 

  57. Liu, W., Dowling, J. P., Murray, W. K., McArthur, G. A., Thompson, J. F., Wolfe, R., et al. (2006). Rate of growth in melanomas: Characteristics and associations of rapidly growing melanomas. Archives of Dermatology, 142(12), 1551–1558. doi:10.1001/archderm.142.12.1551 142/12/1551 [pii].

  58. Menzies, S. W., Moloney, F. J., Byth, K., Avramidis, M., Argenziano, G., Zalaudek, I., et al. (2013). Dermoscopic evaluation of nodular melanoma. JAMA Dermatology, 149(6), 699–709. doi:10.1001/jamadermatol.2013.2466 1675049 [pii].

  59. Chamberlain, A. J., Fritschi, L., & Kelly, J. W. (2003). Nodular melanoma: Patients’ perceptions of presenting features and implications for earlier detection. Journal of the American Academy of Dermatology, 48(5), 694–7010. doi:10.1067/mjd.2003.216 S0190962203000227 [pii].

  60. Busam, K. J. (2005). Cutaneous desmoplastic melanoma. Advances in Anatomic Pathology, 12(2), 92–102. 00125480-200503000-00007 [pii].

    Google Scholar 

  61. Chen, L. L., Jaimes, N., Barker, C. A., Busam, K. J., & Marghoob, A. A. (2013). Desmoplastic melanoma: A review. Journal of the American Academy of Dermatology, 68(5), 825–833, doi:10.1016/j.jaad.2012.10.041 S0190-9622(12)01177-2 [pii].

  62. Jaimes, N., Chen, L., Dusza, S. W., Carrera, C., Puig, S., Thomas, L., et al. (2013). Clinical and dermoscopic characteristics of desmoplastic melanomas. JAMA Dermatology, 149(4), 413–421. doi:10.1001/jamadermatol.2013.2248 1557486 [pii].

  63. Murali, R., Shaw, H. M., Lai, K., McCarthy, S. W., Quinn, M. J., Stretch, J. R., et al. (2010). Prognostic factors in cutaneous desmoplastic melanoma: A study of 252 patients. Cancer, 116(17), 4130–4138. doi:10.1002/cncr.25148.

    Article  PubMed  Google Scholar 

  64. McNutt, N. S., Urmacher, C., Hakimian, J., Hoss, D. M., & Lugo, J. (1995). Nevoid malignant melanoma: Morphologic patterns and immunohistochemical reactivity. Journal of Cutaneous Pathology, 22(6), 502–517.

    Article  CAS  PubMed  Google Scholar 

  65. Deal, T., Mishra, V., Duong, B., & Andea, A. (2012). Pitfalls in dermatopathology: When things are not what they seem [Review]. Expert Review of Dermatology, 7(6), 579–588.

    Article  CAS  Google Scholar 

  66. Schwartz, R. A., Hill, W. E., Hansen, R. C., & Fleishman, J. S. (1980). Verrucous malignant melanoma. The Journal of dermatologic surgery and oncology, 6(9), 719–724.

    Article  CAS  PubMed  Google Scholar 

  67. Kuehnl-Petzoldt, C., Berger, H., & Wiebelt, H. (1982). Verrucous-keratotic variations of malignant melanoma: A clinicopathological study. American Journal of Dermatopathology, 4(5), 403–410.

    CAS  PubMed  Google Scholar 

  68. Feinsilber, D., Kogan, N., Rosati, O. M., Corbella, C., Schröh, R., & Calb, I. (2009). Verrucous melanoma: Differences and similarities between primary and secondary varieties. Dermatología Argentina, 15(2), 106–110.

    Google Scholar 

  69. Rebecca, V. W., Sondak, V. K., & Smalley, K. S. (2012). A brief history of melanoma: From mummies to mutations. Melanoma research, 22(2), 114–122. doi:10.1097/CMR.0b013e328351fa4d 00008390-201204000-00002 [pii].

  70. Balch, C. M. (1981). Measuring melanomas—a tribute to Alexander Breslow. Journal of the American Academy of Dermatology, 5(1), 96–97.

    Article  CAS  PubMed  Google Scholar 

  71. Balch, C. M., Buzaid, A. C., Soong, S. J., Atkins, M. B., Cascinelli, N., Coit, D. G., et al. (2001). Final version of the American Joint Committee on Cancer staging system for cutaneous melanoma. Journal of Clinical Oncology, 19(16), 3635–3648.

    CAS  PubMed  Google Scholar 

  72. Balch, C. M., Gershenwald, J. E., Soong, S. J., Thompson, J. F., Atkins, M. B., Byrd, D. R., et al. (2009). Final version of 2009 AJCC melanoma staging and classification. Journal of Clinical Oncology, 27(36), 6199–6206. doi:10.1200/JCO.2009.23.4799 JCO.2009.23.4799 [pii].

Download references

Author information

Authors and Affiliations

  1. Faculty of Medicine, Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada

    Anand Rotte & Madhuri Bhandaru

Authors
  1. Anand Rotte
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Madhuri Bhandaru
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anand Rotte .

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing AG

About this chapter

Cite this chapter

Rotte, A., Bhandaru, M. (2016). Melanoma—Diagnosis, Subtypes and AJCC Stages. In: Immunotherapy of Melanoma. Springer, Cham. https://doi.org/10.1007/978-3-319-48066-4_2

Download citation

Publish with us

Policies and ethics

Search

Navigation