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Spindle Cell vs. Desmoplastic

Forums General Melanoma Community Spindle Cell vs. Desmoplastic

  • Post
    triggerfish
    Participant

      Hello all!

      Here again with another question.  My Dad's Melanoma is of the spindle-cell nodular variety, which in my understanding is a bit on the unusual side.  Here's my hangup though.  It seems when trying to research this type of tumor specifically, the spindle-cell and desmoplastic terms seem to be used synonymously.  Does anyone out there know if the two are different, or one in the same?  I've been frustrated in my research, as I can't find anything that points me to a way to differentiate the two (if they are indeed even different!).   

      When reading the characteristics of desmoplastic melanoma, my Dad's tumor pretty much fits to a T.  Larger in size (4mm), deeper (Breslow IV), spindle-cell makeup, more frequent in older males, usually found on head and neck, lower incidence of lymphatic involvement despite their size (Dad's SLNB was negative, which of course could be a cooincidence). 

      Still trying to make treatment decision, and from what relatively little information I can find, it appears that WLE with larger margins (done) and possibly radiation to the site to prevent local reoccurences are the go-to adjuvant therapies.  (Not Interferon, as recommended by his Oncologist) 

      Thanks in advance to anyone who has some input! 

       

    Viewing 5 reply threads
    • Replies
        washoegal
        Participant

          Here's a recent article that states they are in fact different and should be treated differently.

          http://www.nature.com/modpathol/journal/v27/n4/full/modpathol2013162a.html

           

          You have to be careful of you research, in the last 2 years the world of melanoma has change drastically.

          washoegal
          Participant

            Here's a recent article that states they are in fact different and should be treated differently.

            http://www.nature.com/modpathol/journal/v27/n4/full/modpathol2013162a.html

             

            You have to be careful of you research, in the last 2 years the world of melanoma has change drastically.

              triggerfish
              Participant

                I did find this particular study, but that's literally almost all I could find.  I haven't been able to locate any sources either about what exactly is different about them, much less how they should be treated differently.  It just doesn't appear that there's much valuable research regarding this variant of Melanoma. 

                This study indicates that they have propensities for certain stains pathologically, but offers really nothing else of significant importance. 

                Thanks for your response though!  Yes, I've been paying clse attention to the dates on articles and studies, as I realize the older ones are likely outdated now.  But that's great advice of course. 

                Becky
                Participant

                  I have wondered the same thing. One one of my sons path reports (he had 3 opinions) it says "spindle cell melanoma". His didnt fit the usual criteria ..he was young (21), was in a very unusual location ( tip of tongue) and did spread to one node. But my googling also came up with spindle cell melanoma=desmoplatic melanoma.

                  He did a year of interferon by the way

                  Becky
                  Participant

                    I have wondered the same thing. One one of my sons path reports (he had 3 opinions) it says "spindle cell melanoma". His didnt fit the usual criteria ..he was young (21), was in a very unusual location ( tip of tongue) and did spread to one node. But my googling also came up with spindle cell melanoma=desmoplatic melanoma.

                    He did a year of interferon by the way

                    Becky
                    Participant

                      I have wondered the same thing. One one of my sons path reports (he had 3 opinions) it says "spindle cell melanoma". His didnt fit the usual criteria ..he was young (21), was in a very unusual location ( tip of tongue) and did spread to one node. But my googling also came up with spindle cell melanoma=desmoplatic melanoma.

                      He did a year of interferon by the way

                      triggerfish
                      Participant

                        I did find this particular study, but that's literally almost all I could find.  I haven't been able to locate any sources either about what exactly is different about them, much less how they should be treated differently.  It just doesn't appear that there's much valuable research regarding this variant of Melanoma. 

                        This study indicates that they have propensities for certain stains pathologically, but offers really nothing else of significant importance. 

                        Thanks for your response though!  Yes, I've been paying clse attention to the dates on articles and studies, as I realize the older ones are likely outdated now.  But that's great advice of course. 

                        triggerfish
                        Participant

                          I did find this particular study, but that's literally almost all I could find.  I haven't been able to locate any sources either about what exactly is different about them, much less how they should be treated differently.  It just doesn't appear that there's much valuable research regarding this variant of Melanoma. 

                          This study indicates that they have propensities for certain stains pathologically, but offers really nothing else of significant importance. 

                          Thanks for your response though!  Yes, I've been paying clse attention to the dates on articles and studies, as I realize the older ones are likely outdated now.  But that's great advice of course. 

                        washoegal
                        Participant

                          Here's a recent article that states they are in fact different and should be treated differently.

                          http://www.nature.com/modpathol/journal/v27/n4/full/modpathol2013162a.html

                           

                          You have to be careful of you research, in the last 2 years the world of melanoma has change drastically.

                          POW
                          Participant

                            In poking around the Internet a bit, I came across several references to "desmoplastic" and "spindle cell" applied to several different types of cancer. Apparently, there terms are basically describing the morphology of the cells– desmoplastic usually refers to fibrous or connective tissue  and spindle usually applies to muscle tissue. Historically, it is not clear whether these are completely different cell types of whether one is a subset of the other– hence the confusion in the nomenclature.

                            It seems that dermatopathologists have long noticed that some melanoms, especially non-pigmented melanomas, have a lot of "desmoplastic" cells in them and others have a lot of "spindle" cells.  Trying to figure out whether these particular cell morphologies are associated with or prognostsic for malignant melanoma is a hot topic of pathology research. 

                            In the article cited here, the researchers think that they have found a set of stains that can clearly distinguish between desmplastic and spindle cell melanomas. Such a set of stains, if confirmed by more pathologists with more patient samples, could help to diagnose more patients as "benign". However, there is sure to be some controvery among pathologists about this and it may take quite a while for this algorithym to be accepted in the field. So for now I would say that we are reading cutting edge pathology research papers.

                            A few other articles that talk about desmoplastic and spindle cell melanoma are:

                            http://www.alphagalileo.org/ViewItem.aspx?ItemId=136104&CultureCode=en

                             

                            http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0560.2007.00891.x/full

                             

                            http://informahealthcare.com/doi/abs/10.1080/00313020412331285336

                              triggerfish
                              Participant

                                Thanks so much for your replies.  It's frustrating when you're trying to make an informed decicion on treatment, and the information just isn't there for my Dad's particular case.  Regardless, I still don't believe that Interferon is the right choice for him, with his MS and significant depression history.  In one of the big studies (I believe it was Kirkwood's), there was only a small subset of individuals who fit my Dad's characteristics in terms of tumor type (there were only 11 in the study), and for some reason these 11 individuals responded poorly to Interferon.  It's difficult to take much from that, since it's such a small sample size.  But what are the chances that all 11 did poorly with Interferon?  It makes me think there must be SOME connection, although it would require further study.  Since this type of melanoma accounts for only about 4% of cases though, I'm not holding my breath that there will be groundbreaking information coming out about Spindle Cell Melanoma.  I understand of course, as it makes sense to do research to benefit the majority of cases.  But it is indeed a little discouraging.

                                 

                                triggerfish
                                Participant

                                  Thanks so much for your replies.  It's frustrating when you're trying to make an informed decicion on treatment, and the information just isn't there for my Dad's particular case.  Regardless, I still don't believe that Interferon is the right choice for him, with his MS and significant depression history.  In one of the big studies (I believe it was Kirkwood's), there was only a small subset of individuals who fit my Dad's characteristics in terms of tumor type (there were only 11 in the study), and for some reason these 11 individuals responded poorly to Interferon.  It's difficult to take much from that, since it's such a small sample size.  But what are the chances that all 11 did poorly with Interferon?  It makes me think there must be SOME connection, although it would require further study.  Since this type of melanoma accounts for only about 4% of cases though, I'm not holding my breath that there will be groundbreaking information coming out about Spindle Cell Melanoma.  I understand of course, as it makes sense to do research to benefit the majority of cases.  But it is indeed a little discouraging.

                                   

                                  triggerfish
                                  Participant

                                    Thanks so much for your replies.  It's frustrating when you're trying to make an informed decicion on treatment, and the information just isn't there for my Dad's particular case.  Regardless, I still don't believe that Interferon is the right choice for him, with his MS and significant depression history.  In one of the big studies (I believe it was Kirkwood's), there was only a small subset of individuals who fit my Dad's characteristics in terms of tumor type (there were only 11 in the study), and for some reason these 11 individuals responded poorly to Interferon.  It's difficult to take much from that, since it's such a small sample size.  But what are the chances that all 11 did poorly with Interferon?  It makes me think there must be SOME connection, although it would require further study.  Since this type of melanoma accounts for only about 4% of cases though, I'm not holding my breath that there will be groundbreaking information coming out about Spindle Cell Melanoma.  I understand of course, as it makes sense to do research to benefit the majority of cases.  But it is indeed a little discouraging.

                                     

                                    warrior4dad
                                    Participant

                                      Hello, 

                                      I wanted to see how things were going for your dad… My best friend's dad was just diagnosed in December 2014 with Spindle Cell Melanoma and the pathology report from the biopsy says "Focally Desmoplastic".  Wondering what new info, if any you have found and where abouts he is being treated? 

                                      I work in the brain cancer field… but this is an area I am unfamiliar with… 

                                       

                                      Thank you! 

                                       

                                      warrior4dad
                                      Participant

                                        Hello, 

                                        I wanted to see how things were going for your dad… My best friend's dad was just diagnosed in December 2014 with Spindle Cell Melanoma and the pathology report from the biopsy says "Focally Desmoplastic".  Wondering what new info, if any you have found and where abouts he is being treated? 

                                        I work in the brain cancer field… but this is an area I am unfamiliar with… 

                                         

                                        Thank you! 

                                         

                                        warrior4dad
                                        Participant

                                          Hello, 

                                          I wanted to see how things were going for your dad… My best friend's dad was just diagnosed in December 2014 with Spindle Cell Melanoma and the pathology report from the biopsy says "Focally Desmoplastic".  Wondering what new info, if any you have found and where abouts he is being treated? 

                                          I work in the brain cancer field… but this is an area I am unfamiliar with… 

                                           

                                          Thank you! 

                                           

                                        POW
                                        Participant

                                          In poking around the Internet a bit, I came across several references to "desmoplastic" and "spindle cell" applied to several different types of cancer. Apparently, there terms are basically describing the morphology of the cells– desmoplastic usually refers to fibrous or connective tissue  and spindle usually applies to muscle tissue. Historically, it is not clear whether these are completely different cell types of whether one is a subset of the other– hence the confusion in the nomenclature.

                                          It seems that dermatopathologists have long noticed that some melanoms, especially non-pigmented melanomas, have a lot of "desmoplastic" cells in them and others have a lot of "spindle" cells.  Trying to figure out whether these particular cell morphologies are associated with or prognostsic for malignant melanoma is a hot topic of pathology research. 

                                          In the article cited here, the researchers think that they have found a set of stains that can clearly distinguish between desmplastic and spindle cell melanomas. Such a set of stains, if confirmed by more pathologists with more patient samples, could help to diagnose more patients as "benign". However, there is sure to be some controvery among pathologists about this and it may take quite a while for this algorithym to be accepted in the field. So for now I would say that we are reading cutting edge pathology research papers.

                                          A few other articles that talk about desmoplastic and spindle cell melanoma are:

                                          http://www.alphagalileo.org/ViewItem.aspx?ItemId=136104&CultureCode=en

                                           

                                          http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0560.2007.00891.x/full

                                           

                                          http://informahealthcare.com/doi/abs/10.1080/00313020412331285336

                                          POW
                                          Participant

                                            In poking around the Internet a bit, I came across several references to "desmoplastic" and "spindle cell" applied to several different types of cancer. Apparently, there terms are basically describing the morphology of the cells– desmoplastic usually refers to fibrous or connective tissue  and spindle usually applies to muscle tissue. Historically, it is not clear whether these are completely different cell types of whether one is a subset of the other– hence the confusion in the nomenclature.

                                            It seems that dermatopathologists have long noticed that some melanoms, especially non-pigmented melanomas, have a lot of "desmoplastic" cells in them and others have a lot of "spindle" cells.  Trying to figure out whether these particular cell morphologies are associated with or prognostsic for malignant melanoma is a hot topic of pathology research. 

                                            In the article cited here, the researchers think that they have found a set of stains that can clearly distinguish between desmplastic and spindle cell melanomas. Such a set of stains, if confirmed by more pathologists with more patient samples, could help to diagnose more patients as "benign". However, there is sure to be some controvery among pathologists about this and it may take quite a while for this algorithym to be accepted in the field. So for now I would say that we are reading cutting edge pathology research papers.

                                            A few other articles that talk about desmoplastic and spindle cell melanoma are:

                                            http://www.alphagalileo.org/ViewItem.aspx?ItemId=136104&CultureCode=en

                                             

                                            http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0560.2007.00891.x/full

                                             

                                            http://informahealthcare.com/doi/abs/10.1080/00313020412331285336

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