Amelanotic melanoma: The great masquerader

Background: Cutaneous melanoma is often recognized by its dark color, but some tumors have little or no pigmentation. Objective: We present the clinical findings of 4 cases of primary cutaneous amelanotic melanoma in which the clinical diagnosis was unsuspected and one case of amelanotic metastatic melanoma. Methods: Five cases of melanoma are reviewed. The clinical morphology of the lesions is presented and discussed. We surveyed the literature regarding conditions that mimic amelanotic melanoma, and we discuss the treatment and prognosis for amelanotic melanoma. Results: Amelanotic melanoma may masquerade as a variety of other conditions leading to a delay in the diagnosis or an inappropriate biopsy technique. The prognosis of amelanotic primary tumors is no different from that for its pigmented counterpart. Conclusion: The clinician should be familiar with the presentation of amelanotic melanoma to facilitate prompt diagnosis.