Wiktoria Malujda, Joanna Michoń, Marta Karkoszka-Stanowska, Dorota Małgorzata Wrześniok

Amelanotic melanoma as a diagnostic and therapeutic challenge

DOI: 10.32383/farmpol/224737

2026-07-14

Research subject. Melanoma is one of the most prevalent types of skin cancer. Both pigmented and nonpigmented types can be distinguished; however, data concerning the amelanotic variant of this neoplasm is currently very scarce. Insufficiently defined clinical criteria and a complex diagnostic process contribute to the delayed diagnosis of this melanoma. Limited therapeutic options, combined with the high aggressiveness of the lesions, result in an unfavorable prognosis and a significant mortality rate. The diagnostic methods and innovative treatment models currently being developed are aimed at increasing the likelihood of early detection of amelanotic melanoma and a long-term improvement in patients’ outcomes.

Research object. The purpose of this research was to gather current information on diagnostic and therapeutic methods used in the treatment of amelanotic melanoma and to compare them with models still at the research stage.

Materials and methods. The literature review was conducted using the PubMed, Google Scholar and Scopus databases, as well as the following keywords: “melanoma”, “amelanotic melanoma”, “diagnosis”, “therapy”and “epidemiology”. The study includes publications from 2020 to 2025. Several older articles were also included to supplement the information gathered.

Results. Amelanotic melanoma, most frequently diagnosed in patients over 50 years of age, accounts for approximately 2–20% of all reported cases of this malignancy. Assessment of lesion pigmentation and vascular patterns may aid in its diagnosis, but these features alone are insufficient as definitive diagnostic criteria. Additional identifying characteristics include asymmetry of shape and the presence of blue-gray dots within the lesion structure. Reports in the literature also describe white lines on the tumor surface and occasional brown pigmentation, which may further support the diagnostic process. The standard treatment consists of surgical excision of the lesion with an appropriate margin of healthy tissue. Emerging therapeutic strategies, including immunotherapy and targeted therapies, have the potential to substantially improve patient prognosis.

Conclusion. Current statistics define amelanotic melanoma as a tumor with a high probability of misdiagnosis, with approximately 89% of reported cases being classified as other benign or malignant lesions. Techniques aimed at improving the effectiveness of the diagnostic process include combining dermatoscopy with reflective confocal microscopy, the use of videodermatoscopy, or employing various biomarkers. The lack of or late diagnosis of amelanotic melanoma contributes to the low effectiveness of its treatment.

Keywords: melanoma, amelanotic melanoma, diagnosis, therapy, epidemiology.

© Farm Pol, 2026, 82(1): 27–35