Types of Melanoma

Melanoma can begin in different parts of the body and can appear in many forms. The most common type is skin (cutaneous) melanoma, but melanoma can also develop in the eyes or on internal mucosal surfaces like the mouth, nose, or genitals. Each type may look different and require its own approach to treatment.

Determining which type of melanoma you have is important for deciding how to treat it. Below are the most common types of melanomas and how they typically present.  At Columbia, you will receive state of the art care for any type of melanoma you have- regardless of how common it is, or how far along it has progressed. Our specialists at the Melanoma Center, which includes world-renowned experts in oncology, surgery, radiology, and more, ensure you have access to the most advanced melanoma treatments available today.

Cutaneous (skin) melanoma

Cutaneous melanoma is the most common type of melanoma. It begins in the skin and is usually caused by exposure to ultraviolet (UV) light, most commonly from the sun. There are two main types of skin melanoma: 

• In situ melanoma is found only in the top layer of skin (the epidermis). It is highly curable and will not spread once the lesion has been removed. 
• Invasive melanoma spreads deeper into the skin layers and can travel to other parts of the body, including the lymph nodes, lungs, liver, and brain. 

There are four main subtypes of cutaneous melanoma:

Superficial spreading melanoma

This is the most common type of cutaneous (skin) melanoma, making up about 70% of all skin melanoma cases. It usually affects younger people and appears as a flat or slightly raised patch with irregular edges and multiple colors—often tan, brown, black, red, or even white or blue. It tends to appear on the trunk, legs, or upper back. It typically starts out growing along the surface of the skin. 

Lentigo maligna

Lentigo maligna tends to develop in older adults with sun-damaged skin. It appears as a flat or slightly elevated tan to dark brown spot, usually on areas that get a lot of sun, such as the face, ears, arms, or upper torso. When this type of melanoma becomes invasive and spreads deeper into the skin, it is called lentigo maligna melanoma. 

Acral-lentiginous melanoma

Acral-lentiginous melanoma appears on the palms of the hands, soles of the feet, or under the nails. It may look like a dark streak or bruise. Unlike other types, this melanoma is not related to sun exposure. It is more commonly found in people with darker skin tones and can grow quickly if not found early.

Nodular melanoma

Nodular melanoma is a more aggressive form that grows deeper into the skin more quickly. It typically looks like a firm, raised bump that may be black but can also appear blue, red, gray, or even the same color as the surrounding skin. This form of melanoma is frequently found on the trunk, legs, arms, and scalp. It is the second most common form of melanoma, and more frequently impacts those over the age of 50 and men. 

Melanoma in the eyes (ocular)

Melanoma can also develop in the eye. This is called ocular melanoma. It can affect different parts of your eyes, including: 

• The layer of the eye between the retina and the white outer layer of the eye, called the choroid. This type of melanoma is called uveal melanoma, which is the most common type of eye melanoma. 
• The eyelids 
• The clear mucosal surface of the eye, called the conjunctiva, which covers the eye’s surface and the inside of the eyelids. This type of melanoma is called conjunctival melanoma.

Symptoms of eye melanoma may include blurry vision, changes in the shape of the pupil, a dark spot on the iris, flashes of light, or partial loss of vision. In many cases, it is found during a routine eye exam.

Mucosal melanoma

Mucosal melanoma is a rare type that begins in the moist, inner linings of the body—such as the mouth, nose, throat, digestive tract, urinary tract, or vagina. Because these areas are not visible from the outside, mucosal melanoma is often diagnosed at a later stage. 

More than half of mucosal melanomas begin in the head and neck area. About one-quarter begin in the anal or rectal area, and another 20% begin in the female genital tract. It may cause bleeding, pain, discolored lesions, or sores that don’t heal. Melanomas originating in mucosal surfaces lining the esophagus, gallbladder, bowel, conjunctiva, urethra, and other sites are far less common. Symptoms depend on where the melanoma starts and can be mistaken for more common conditions.