Skin Cancer Research Today is a free monthly online journal that collates and summarizes the latest research about Skin Cancer, including details on identification, causes, prevention, treatment.

Discordance in the histopathologic diagnosis of difficult melanocytic neoplasms in the clinical setting.

Lodha S, Saggar S, Celebi JT, Silvers DN

Department of Dermatology, Columbia University, New York, NY 10032, USA.

BACKGROUND: The gold standard for diagnosing melanocytic neoplasms is by histopathologic examination. However, lack of agreement among expert dermatopathologists in evaluating these tumors has been well established in experimental settings. OBJECTIVE: This study examines the discordance among dermatopathologists in evaluating difficult melanocytic neoplasms in a clinical setting where the diagnosis impacts patient management. METHODS: Retrospective review of consultation reports over a 6-year period. Results: There was complete agreement among the consultants in 54.5% of the cases. However, a high level of disagreement was found in 25% of the cases. LIMITATIONS: The analysis was limited to two consultant dermatopathologists. CONCLUSIONS: There are limitations to the practical applications of histologic criteria for diagnosing difficult melanocytic tumors. It is not malpractice for a pathologist to have rendered a diagnosis that did not predict clinical outcome as long as 'standard of care' has been followed in his/her evaluation of the specimen.

Published 12 March 2008 in J Cutan Pathol, 35(4): 349-52.
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