Impact of second histopathological review of melanocytic skin lesions at a melanoma reference center in Brazil.

Abstract

After the biopsy of a suspicious melanocytic lesion, patients depend on the pathologist's precision of specimen evaluation. We assessed the agreement between histopathological reports made by general pathologists and reviewed by a dermatopathologist to evaluate the impact on the patient's management. In 79 cases analyzed, underdiagnosis was observed in 21.6% and overdiagnosis in 17.7%, resulting in changes in the patients' conduct. The assessment of the Clark level, ulceration and histological type showed mild agreement (P<0.001); the Breslow thickness, surgical margin, and staging showed moderate agreement (P<0.001). A dermatopathologist's review should be incorporated into the routine of reference services for pigmented lesions.