Collecting Tissue Samples From Patients With Melanocytic Nevi or Pigmented Lesions

OBJECTIVES:

Primary

- Obtain tissue from benign melanocytic nevi and LCMN for experimental study.

- Refine culture and immortalization methods for melanocytes derived from melanocytic
nevi that permits in vitro expansion of these cells for functional study.

- Correlate clinical and dermoscopic observations of primary melanoma with histopathology
to establish standards for sampling primary melanoma in a possible future study.

Secondary

- Obtain, prospectively, a set of tissue samples of melanocytic nevi and primary melanoma
with detailed clinical information for evaluating novel diagnostic techniques and for
the basis of a nevus/primary melanoma tissue microarray.

OUTLINE: Patients are stratified according to diagnosis (children ≤ 5 years of age with
large congenital melanocytic nevi vs adults with ≥ 100 acquired melanocytic nevi vs adults
with suspected primary melanoma).

Patients undergo extensive full-body photography to document the number, type, and location
of melanocytic nevi and pigmented lesions. Patients will also undergo excisional or staged
(incisional and excisional) biopsy* of the melanocytic nevi or pigmented lesions.
Dermoscopic images are performed before and after biopsy* on both clinically benign
melanocytic nevi and pigmented lesions that are clinically suspicious for primary melanoma.
Patients with a diagnosis of malignant melanoma receive standard care for primary melanoma.

NOTE: *Patients with lesions < 4 mm OR lesions 4-6 mm with ≤ 1-axis symmetry do not undergo
biopsy.

Biopsy tissue will be used for immortalization of nevus-derived melanocytes and mutation
screening (e.g., somatic mutations at codon 599 of BRAF and codon 61 of NRAS) and functional
studies (e.g., gene expression analysis) of nevus-derived melanocytes.

Patients diagnosed with malignant melanoma and < 100 acquired melanocytic nevi are followed
every 6 months for ≥ 2 years and then annually for ≥ 3 years. All other patients are
followed every 6 months.

PROJECTED ACCRUAL: A total of 110 patients will be accrued for this study.