ASK THE EXPERT: What is spindle cell melanoma?

By Amy Amonette Huber, MD

Dr. Huber is a board-certified dermatologist and fellowship trained Mohs surgeon.  She practices at the Memphis Dermatology Clinic in Memphis, Tennessee and is a member of the American Academy of Dermatology, the American College of Mohs Surgery and the Dermatology Foundation's Annenberg Circle. Dr. Huber has served as a board member for the Women's Dermatologic Society.

Q: My sister has been diagnosed with spindle cell melanoma, and we don’t know exactly what it is. How is it different from regular melanoma? Is it more dangerous?

A: Spindle cell melanoma, also known as desmoplastic melanoma, is a rare form of melanoma that is locally aggressive and tends to have a high recurrence rate even with treatment.

This type of melanoma — the name refers to the spindle-like shape of the cancer cells — is most commonly found on sun-exposed skin, in particular the head and neck.  Because these lesions can involve nerves, they tend to be more symptomatic than regular melanomas.  Spindle cell melanomas may arise from a preexisting lesion or without a precursor.  These lesions may be pigmented or flesh-colored.  This subtype of melanoma is most common in elderly, male patients, but women are at risk as well.

All melanoma lesions should be treated aggressively because of their risk of spreading to other parts of the body.  Spindle cell melanomas tend not to spread throughout the body as readily as other types of melanomas; however, they often recur locally and can be fatal depending on the location and if the local invasion is deep enough.  Unfortunately, these lesions are usually deep by the time the diagnosis is made.

Any new head or neck lesion, whether it is darkly pigmented or not, should be evaluated by a medical professional.