New and evolving concepts of melanocytic nevi and melanocytomas

Abstract

In daily clinical practice melanocytic nevi are commonly encountered. Traditionally, both benign and malignant melanocytic tumors have been sub-classified by their histopathologic characteristics with differing criteria for malignancy applied to each group. Recently, many of the mutations that initiate nevus formation have been identified and specific sets of mutations are found in different subtypes of nevi. Whereas a single mutation appears sufficient to initiate a nevus, but is not enough to result in melanoma, specific combinations of mutations have been identified in some melanocytic tumors that are regarded to be of low biologic potential. The term “melanocytoma” has recently been proposed by the World Health Organization to describe those tumors that demonstrate genetic progression beyond the single mutations that are found in nevi but are not frankly malignant. Melanocytomas occupy intermediate genetic stages between nevus and melanoma and likely have an increased risk of malignant transformation as compared to nevi. This review provides an update on the broad spectrum of melanocytic nevi and melanocytomas and outlines their key histopathologic and genetic features.

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Acknowledgements

I am very grateful to my many generous colleagues and mentors over the years. My work with Dr. Boris Bastian has greatly informed my view of the genetics of melanocytic tumors. Dr. Philip LeBoit provided micrographs. Thank you to Dr. Richard Jordan for careful reading of the manuscript and helpful suggestions. This work was supported by the National Cancer Institute at the National Institutes of Health (grant number 1R35CA220481).

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Correspondence to Iwei Yeh.

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Yeh, I. New and evolving concepts of melanocytic nevi and melanocytomas. Mod Pathol 33, 1–14 (2020). https://doi.org/10.1038/s41379-019-0390-x

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