Melanocytic tumours of uncertain malignant potential (MELTUMPs)—a diagnostic and management dilemma

Background: Melanocytic tumours of uncertain malignant potential (MELTUMPs) represent melanocytic proliferations within the dermis and are thereby associated with a potential risk of disease dissemination and metastases. However, there is a paucity of data regarding these lesions, their malignant potential and thus their management.; Methods: This is a retrospective evaluation of all MELTUMPs treated in a single tertiary plastic surgery unit to establish patient demographics, clinical management and outcomes including recurrence and regional and distant metastases.; Results: Forty-two patients were treated for MELTUMPs between 2005 and 2011 in our unit. The mean Breslow thickness was 0.85 mm (range in situ disease to 5 mm). A complete data set was available for 37 of these patients, of whom, 32 (86 %) underwent wider excision with a 1-cm margin and 5 (14 %) with 2-cm margin. The mean follow-up time was 23 months (range 2 to 48 months). One patient developed locally recurrent disease, one patient developed regional metastases and one patient died of metastatic disease.; Conclusions: MELTUMPs present a diagnostic and management dilemma with a paucity of agreed strategies for ongoing patient care. We propose that all MELTUMPs should be treated using a melanoma strategy under the care of a skin cancer multidisciplinary team.; Level of Evidence: Level IV, risk / prognostic study. © 2014, Springer-Verlag Berlin Heidelberg.