Mihaela Paula Toader, Victor Vlad Costan, Ştefan Toader, Alice Chirana, Mihai Ciofu, Elena Porumb Andrese, Daciana Elena Branisteanu
Abstract: Background: The role of angiogenesis in tumoral growth and progression is well documented for a number of solid tumors. The importance of tumoral angiogenesis expressed as microvessel density in cutaneous malignant melanoma is still controversial, and subject of conflicting data reports in the literature.
Material and method: 14 formalin-fixed, paraffin-embedded excision pieces of cutaneous malignant melanoma of the face were examined. All cases were advanced primary cutaneous melanomas, with a Clark level ranging between III to V. 3 μm sections were prepared for immunohistochemical analysis. CD31 monoclonal antibody was used to mark out vascular endothelium. Microvessel density (MVD) was assessed using hot-spot method in normal tissue, peritumoral and intratumoral areas for each case.
Results: Overall microvessel density was increased in thick cutaneous melanoma. Vessels in the peritumoral areas were larger and were found in greater number compared to those found in normal tissue. In cases with a dense peritumoral inflammatory infiltrate we found the highest vascular density. Intratumoral angiogenesis was moderate in most cases, with irregular, smaller or collapsed vessels. In one case of ulcerated, infiltrative melanoma (Clark level V), highly pigmented, with intravascular tumoral emboli (noted in routine haematoxylin and eosin examination) there was an increased intratumoral microvessel density, with an irregular distribution throughout the whole tumoral area. We also found numerous neovessels inside connective septum penetrating the tumor.
Conclusions: Increased overall microvessel density in thick cutaneous melanoma suggest a possible relation between tumor thickness – known as an independent prognostic factor in melanoma, and the number of new blood vessels found in peritumoral and intratumoral areas.