{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T06:30:10Z","timestamp":1786516210898,"version":"build-2736575974"},"reference-count":13,"publisher":"Danish Medical Association","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dan Med J"],"abstract":"<jats:p>INTRODUCTION. Turnaround time (TAT) for routine skin specimens may be prolonged at times, delaying diagnosis and treatment in cases with a unexpected high-risk neoplasia. This quality improvement study assessed the prevalence, types and characteristics of such cases.\n\nMETHODS. This was a descriptive study of all routine skin specimens submitted by general practitioners (GPs) and private dermatologists in 2022-2023 at the Department of Pathology, Viborg Regional Hospital, Denmark. From Systematized Nomenclature of Medicine (SNOMED) codes, various premalignant and malignant neoplasias were identified; melanocytic and soft tissue neoplasms were included.\n\nRESULTS. Among 33,280 routine specimens, 77 (0.23%) were a high-risk premalignant or malignant neoplasia: 66 melanocytic (54 melanomas, 0.16%) and 11 sarcomas. Superficial spreading melanoma (n = 36) and the in situ variant (n = 10) were the most frequent high-risk neoplasia in lesions clinically assessed as benign. Among melanocytic lesions, 61% had involved\/unassessable margins, and 67% of melanomas had a depth \u2265 1.0 mm. The mean TAT was 64 calendar days. Mean age: 64.1 years, with a notable proportion aged 41-50 years. Referrals: GPs 73%, dermatologists 26%, surgeons 1%. Procedures: excision 58%, curettage 25%, biopsy 10%, unspecified 7%. Suspicious shape\/colour features were noted in 36% of melanocytic lesions. 7.5% had prior melanoma.\n\nCONCLUSIONS. Unexpected high-risk neoplasia are rare (0.23%) but often advanced, highlighting the need for improved clinical assessment and a short TAT for routine skin specimens. The results serve as a reference for future AI-based screening.\n\nFUNDING. None.\n\nTRIAL REGISTRATION. Not relevant.<\/jats:p>","DOI":"10.61409\/a09250776","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T05:52:26Z","timestamp":1778133146000},"page":"1-9","source":"Crossref","is-referenced-by-count":0,"title":["Unexpected high-risk neoplasias among routine skin specimens"],"prefix":"10.61409","author":[{"given":"Karen Marie","family":"Egsgaard","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steen","family":"Jensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomasz Piotr","family":"Tabor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"40208","published-online":{"date-parts":[[2026,4]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Urbancek S, Fedorcova P, Tomkova J, Sutka R. Misdiagnosis of melanoma: a 7-year single-center analysis. J Pigment Disord. 2015;2(9):1-4. https:\/\/doi.org\/10.4172\/2376-0427.1000208","DOI":"10.4172\/2376-0427.1000208"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Izikson L, Sober AJ, Mihm MC, Zembowicz A. Prevalence of melanoma clinically resembling seborrheic keratosis: analysis of 9204 cases. Arch Dermatol. 2002;138(12):1562-1566. https:\/\/doi.org\/10.1001\/archderm.138.12.1562","DOI":"10.1001\/archderm.138.12.1562"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Nervil GG, Vestergaard T, Klausen S, et al. Impact of skin biopsy practices: a comprehensive nationwide study on skin cancer and melanoma biopsies. J Eur Acad Dermatol Venereol. 2025;39(7):1267-1277. https:\/\/doi.org\/10.1111\/jdv.20371","DOI":"10.1111\/jdv.20371"},{"key":"ref3","unstructured":"Dummer R, Luzar B, Miller K. Pleomorphic dermal sarcoma. In: Cree IA, Goldman-L\u00e9vy G, Lokuhetty D, et al., eds. WHO classification of tumours: skin tumours. 5th ed. International Agency for Research on Cancer, 2025:623-624"},{"key":"ref4","unstructured":"Beer TW, Calonje JE. Atypical fibroxanthoma. In: Cree IA, Goldman-L\u00e9vy G, Lokuhetty D, et al., eds. WHO classification of tumours: skin tumours. 5th ed. International Agency for Research on Cancer, 2025:620"},{"key":"ref5","unstructured":"Calonje E, Brenn T, Lazar AJ, et al., eds. Tumors of the surface epithelium. In: McKee's pathology of the skin: with clinical correlations. 5th ed. Elsevier, 2020:1200"},{"key":"ref6","unstructured":"Comenero I, Alvarez-Twose I, Torrelo A, et al. Mastocytosis. In: Cree IA, Goldman-L\u00e9vy G, Lokuhetty D, et al., eds. WHO classification of tumours: skin tumours. 5th ed. International Agency for Research on Cancer, 2025:335-338"},{"key":"ref7","unstructured":"Danske Multidisciplin\u00e6re Cancer Grupper. Sentinel node biopsi procedure for melanom. Kliniske retningslinjer. Danske Multidisciplin\u00e6re Cancer Grupper, 2025. www.dmcg.dk\/Kliniske-retningslinjer\/kliniske-retningslinjer-opdelt-paa-dmcg\/melanom\/kirurgisk-behandling\/sentinel-node-biopsi-procedure-for-melanom\/ (13 Sep 2025)"},{"key":"ref8","unstructured":"Hansen NN. Patienter venter n\u00e6sten dobbelt s\u00e5 l\u00e6nge p\u00e5 at komme til hudl\u00e6ge og psykiater som for syv \u00e5r siden. DR, 12 May 12 2024. www.dr.dk\/nyheder\/indland\/patienter-venter-naesten-dobbelt-saa-laenge-paa-komme-til-hudlaege-og-psykiater-som (30 Aug 2025)"},{"key":"ref9","unstructured":"PLO. PLO Analyse. Antallet af patienter hos de praktiserende l\u00e6ger stiger fortsat. laeger.dk. PLO, 2018. https:\/\/laeger.dk\/media\/o2bppmxq\/plo_analyse_-_antallet_af_patienter_stiger_fortsat_hos_de_praktiserende_laeger.pdf (1 Mar 2025)"},{"key":"ref10","unstructured":"Danske Multidisciplin\u00e6re Cancer Grupper. Kutant melanom (moderm\u00e6rkekr\u00e6ft). Klinisk unders\u00f8gelse - anamnese og objektiv unders\u00f8gelse. Kliniske retningslinjer. Danske Multidisciplin\u00e6re Cancer Grupper, 2022. www.dmcg.dk\/kliniske-retningslinjer\/kliniske-retningslinjer-opdelt-paa-dmcg\/melanom\/diagnostik\/kutant-melanom-modermarkekraft-klinisk-undersogelse--anamnese-og-objektiv-undersogelse\/ (1 Mar 2025)"},{"issue":"2","key":"ref11","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1016\/S0733-8635(18)30901-X","article-title":"The clinical features of malignant melanoma","volume":"3","author":"RJ","year":"1985","unstructured":"Friedman RJ, Rigel DS. The clinical features of malignant melanoma. Dermatol Clin. 1985;3(2):271-283","journal-title":"Dermatol Clin"},{"key":"ref12","unstructured":"Moltsen M. Graverende fejl i grundlaget for offentlig millioninvestering i hudkr\u00e6ft-app. Onkol Tidsskr. 23 Jun 2025. https:\/\/onkologisktidsskrift.dk\/behandlinger\/hudkraeft\/3762-graverende-fejl-i-grundlaget-for-offentlig-millioninvestering-i-hudkraeft-app.html (9 Nov 2025)"}],"container-title":["Danish Medical Journal"],"original-title":[],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T05:53:46Z","timestamp":1786514026000},"score":1,"resource":{"primary":{"URL":"https:\/\/ugeskriftet.dk\/dmj\/A09250776"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":13,"URL":"https:\/\/doi.org\/10.61409\/a09250776","relation":{},"ISSN":["2245-1919"],"issn-type":[{"value":"2245-1919","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]}}}