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Superficial Spreading Melanoma

About 70% of melanomas are superficial spreading melanoma  (SSM). They develop out of a pre existing nevus , which are the brown spots that every person has a few of. A nevus is a potential melanoma precursor lesion. There might be an incubation period of 1 to 5 years where the nevus is slowly growing, changing color, getting somewhat more raised and perhaps getting surrounded by a red line.

All those are warning signs that this nevus is dysplastic, moving towards malignant transformation. This nevus needs to be surgically removed to avoid trouble down the road. If it is not removed, the surface may become glossy and become more irregular.

Progression of dysplastic nevus to early melanoma

Here is an image of a superficially spreading melanoma where there are areas of regression of the tumor (lighter color), but the remainder of it is spreading (dark color).

There may be some notching or indentation at the perimeter of the lesion and the color may become deeper pigmented, at some areas even black looking. A small patch of the lesion may even turn amelanotic (amelanotic melanoma, looks skin colored). Women tend to have more of this type of melanoma. It tends to be less aggressive and has a better prognosis.

References

1. Cancer: Principles &Practice of Oncology, 4th edition, by V.T. De Vita,Jr.,et. al J.B.     LippincottCo.,Philadelphia, 1993.Vol.2: Chapter on Cutaneous melanoma.

2. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999.     Chapter 126, p. 843-845.

3. Cancer: Principles&Practice of Oncology. 5th edition, volume 2. Edited by Vincent T.     DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Chapter on Cutaneous melanoma.

4. SA Rosenberg et al. Ann Surg 1998 Sep 228(3): 307-319.

5. SA Rosenberg  Nature 2001 May 17;411(6835):380-384.

6. T Todo et al. Proc Natl Acad Sci U S A 2001 May 15 ( page not available yet).

7. GJ Tsioulias et al. Ann Surg Oncol 2001 Apr;8(3):198-203.

8. Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier

9. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

Last modified: April 21, 2021

Disclaimer
This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.