{"id":10138,"date":"2023-06-23T07:44:23","date_gmt":"2023-06-23T06:44:23","guid":{"rendered":"https:\/\/www.ilmelanoma.com\/melanoma\/rare-variants-of-melanoma\/melanoma-on-blue-nevus\/"},"modified":"2026-10-17T10:07:22","modified_gmt":"2026-10-17T09:07:22","slug":"melanoma-on-blue-nevus","status":"publish","type":"page","link":"https:\/\/www.ilmelanoma.com\/en\/melanoma\/rare-variants-of-melanoma\/melanoma-on-blue-nevus\/","title":{"rendered":"Melanoma on blue nevus"},"content":{"rendered":"<div class=\"im26-diagnosis-guide\">\n<nav class=\"im26-dg-toc\" aria-label=\"On this page\"><strong>On this page<\/strong><\/p>\n<ol>\n<li><a href=\"#rf-distinzione\">Blue nevus and associated melanoma<\/a><\/li>\n<li><a href=\"#rf-cambiamenti\">Changes needing assessment<\/a><\/li>\n<li><a href=\"#rf-istologia\">The role of histology<\/a><\/li>\n<li><a href=\"#rf-gestione\">Treatment and surveillance<\/a><\/li>\n<\/ol>\n<\/nav>\n<section class=\"im26-dg-section\" id=\"rf-distinzione\">\n<h2>Blue nevus and associated melanoma<\/h2>\n<p>A blue nevus is generally a benign melanocytic lesion. Its blue or blue-grey colour reflects pigment deep in the dermis and the way light travels through tissue. Malignant transformation is rare; not every blue nevus should be regarded as early melanoma.<\/p>\n<p>\u201cMelanoma arising in a blue nevus\u201d concerns a malignancy associated with this family of lesions. Literature also uses terms such as blue-nevus-like melanoma. Association with a pre-existing nevus needs documentation rather than inference from blue colour alone.<\/p>\n<p>Historical descriptions include work by Allen and Spitz. The scalp and other sites, including extremities and trunk, appear in case series. A presumed peak age of 45 or male predominance does not provide universal diagnostic criteria.<\/p>\n<\/section>\n<section class=\"im26-dg-section\" id=\"rf-cambiamenti\">\n<h2>Changes needing assessment<\/h2>\n<p>Persistent enlargement, a new nodule, ulceration, bleeding or change from the usual appearance needs assessment. Sizes described in individual tumour reports are not thresholds; a lesion need not reach several centimetres before being checked.<\/p>\n<p>A new blue lesion in adulthood or a changing deep lesion may require differential diagnosis. <a href=\"https:\/\/www.ilmelanoma.com\/en\/melanoma\/melanoma-diagnosis\/dermoscopy\/\">Dermoscopy<\/a> contributes, but the depth of some lesions limits its ability to describe the entire tissue. A photograph of a benign blue nevus explains the context and is not a proven example of melanoma.<\/p>\n<div class=\"im26-dg-gallery\">\n<figure><a href=\"https:\/\/www.ilmelanoma.com\/wp-content\/uploads\/2023\/06\/nevo-blu-2.jpg\" aria-label=\"Open original image\"><img loading=\"lazy\" src=\"https:\/\/www.ilmelanoma.com\/wp-content\/uploads\/2023\/06\/nevo-blu-2.jpg\" width=\"300\" height=\"225\" loading=\"lazy\" decoding=\"async\" alt=\"Melanoma on blue nevus: archive image\"\/><\/a><figcaption>Benign blue nevus: contextual archive image, not a proven example of melanoma.<\/figcaption><\/figure>\n<\/div>\n<\/section>\n<section class=\"im26-dg-section\" id=\"rf-istologia\">\n<h2>The role of histology<\/h2>\n<p>The pathologist assesses the relationship between blue-nevus and suspicious components, atypia, mitotic activity, necrosis and architecture. Spindle or epithelioid cells may form bundles or nodules; giant cells and inflammatory infiltrates may occur. Not every feature is required, and the malignant component need not be confined to the edge.<\/p>\n<p>Cellular blue nevi, atypical lesions and melanoma can be difficult to distinguish. Representative tissue is needed, with dermatopathology review for complex cases. <a href=\"https:\/\/www.ilmelanoma.com\/en\/melanoma\/istopatologia-del-melanoma\/\">Immunohistochemistry<\/a> and selected molecular investigations support classification without replacing morphology.<\/p>\n<p>Abundant pigment or an inflammatory infiltrate cannot alone establish benignity or malignancy. The complete report matters more than one word or an isolated image.<\/p>\n<\/section>\n<section class=\"im26-dg-section\" id=\"rf-gestione\">\n<h2>Treatment and surveillance<\/h2>\n<p>When melanoma is confirmed, assessment establishes extent, resectability and further investigation needs. It can behave aggressively, but small series cannot predict the same outcome for everyone. Depth and location require specialist interpretation of pathology findings.<\/p>\n<p><a href=\"https:\/\/www.ilmelanoma.com\/en\/guides\/treatment\/\">Surgery<\/a> is central to resectable disease; lymph node procedures and systemic treatment are discussed according to the whole situation. Blue colour does not identify a targeted treatment or replace molecular analysis when indicated.<\/p>\n<p>A stable blue nevus may be managed differently from a changing lesion. Follow-up should match the actual diagnosis, avoiding both generalised alarm and reassurance based solely on a familiar mole-like appearance.<\/p>\n<\/section>\n<aside class=\"im26-dg-related\">\n<h2>Continue reading<\/h2>\n<ul>\n<li><a href=\"https:\/\/www.ilmelanoma.com\/en\/melanoma\/rare-variants-of-melanoma\/\">Rare variants of melanoma<\/a><\/li>\n<li><a href=\"https:\/\/www.ilmelanoma.com\/en\/melanoma\/rare-variants-of-melanoma\/nevoid-melanoma\/\">Nevoid melanoma<\/a><\/li>\n<li><a href=\"https:\/\/www.ilmelanoma.com\/en\/guides\/diagnosis\/\">The diagnostic pathway<\/a><\/li>\n<li><a href=\"https:\/\/www.ilmelanoma.com\/en\/guides\/treatment\/\">Understanding treatment<\/a><\/li>\n<\/ul>\n<\/aside>\n<section class=\"im26-dg-sources\">\n<h2>Sources and update<\/h2>\n<ul>\n<li><a href=\"https:\/\/www.cancer.gov\/types\/skin\/hp\/melanoma-treatment-pdq\">NCI \u2014 Melanoma Treatment (PDQ)<\/a><\/li>\n<li><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/26909585\/\">Cellular blue nevomelanocytic lesions \u2014 clinicopathological study<\/a><\/li>\n<li><a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0893395222035384\">Melanoma arising in association with blue nevus \u2014 study of 24 cases<\/a><\/li>\n<\/ul>\n<p>Editorial revision: 17 October 2026. This information does not replace medical assessment. For very rare variants, some evidence comes from small series or case reports.<\/p>\n<\/section>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>A common blue nevus is benign. This guide explains its rare association with melanoma, changes needing assessment and the role of histology.<\/p>\n","protected":false},"author":13,"featured_media":10136,"parent":10105,"menu_order":8,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-10138","page","type-page","status-publish","has-post-thumbnail","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Melanoma on blue nevus - Il Melanoma<\/title>\n<meta name=\"description\" content=\"Blue nevus melanoma was first described by Allen and Spitz and arises primarily on a cellular blue nevus.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ilmelanoma.com\/en\/melanoma\/rare-variants-of-melanoma\/melanoma-on-blue-nevus\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Melanoma on blue nevus - 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