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Background: Differentiating between vertical growth cutaneous malignant melanoma (CMM) and predominantly intradermal benign melanocytic nevus (BMN) can be extremely challenging. Reversion-inducing cysteine-rich protein with Kazal motifs (RECK) is an endogenous inhibitor of many proteins that promote tumor invasion and progression. We investigated the difference in expression of RECK between CMM and BMN to determine whether RECK could assist in their differentiation., Materials and Methods: The expression of RECK in skin biopsies of 39 cases, including 20 cases of CMM and 19 cases of BMN, was evaluated by immunohistochemistry., Results: Two out of 20 cases (10%) of CMM were positive for RECK, and all (100%) 19 cases of BMN exhibited positivity at different levels. In 7/8 cases of CMM adjacent to benign nevus cells, malignant melanoma cells did not express RECK, but benign nevus cells stained positively., Conclusion: These findings suggest that immunohistochemical staining for RECK could be useful in the differential diagnosis between CMM and BMN., (Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.)

Polypoid melanoma represents a distinct variant of melanoma characterized by an ulcerated exophytic nodule. Although this melanocytic tumor is usually restricted to the papillary dermis, it presents with a thick Breslow level and aggressive course. Its rapidly growing vertical phase and its amelanotic nature frequently simulate benign or non-aggressive entities; leading to a delay in biopsy and resulting in an increased risk of metastasis at the time of the diagnosis. [ABSTRACT FROM AUTHOR]