Angiotropic Metastatic Malignant Melanoma

Cr, Shea; Ma, Kline; J, Lugo; Ns, McNutt

doi:10.1097/00000372-199502000-00011

Cited by 28 publications

(24 citation statements)

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“…However, some cases may show such prominent epidermotropism that they can mimic melanoma in situ. 5 Also, some studies have suggested that angiotropism could be a reliable clue to the diagnosis of EMM [17][18][19][20] ; however, this phenomenon has also been observed in primary melanomas. In this series, we did not observe features of angiotropism in any of our EMM cases.…”

Section: Discussionmentioning

confidence: 99%

Cutaneous Metastases of Malignant Melanoma: A Clinicopathologic Study of 192 Cases With Emphasis on the Morphologic Spectrum

Plaza

Torres‐Cabala²,

Evans

et al. 2010

The American Journal of Dermatopathology

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Metastatic melanoma represents one of the most common types of cutaneous metastases. In up to 5% of patients, metastatic melanoma can be the first manifestation of the disease. For the most part, the histologic diagnosis of metastatic melanoma poses little diagnostic difficulty; however, some metastases may adopt unusual or unfamiliar appearances mimicking other benign and malignant conditions. We present a study of 192 cases of cutaneous metastatic melanomas with special emphasis on their spectrum of morphologic features. The patients were 115 men and 77 women, 23-91 years of age (mean 57 years). Most tumors were located on the proximal legs, scalp, and arms and ranged from 0.8 to 3.0 cm. One hundred ten cases showed the classic morphologic appearance of melanoma (well-circumscribed epithelioid dermal/subcutaneous nodule), 82 cases showed unusual histologic appearances that mimicked other benign and malignant neoplasms. In 16 patients (8.3%), there was no evidence of primary melanoma and the cutaneous metastasis was the only manifestation of the disease. The histologic diagnosis of cutaneous metastatic melanoma can pose difficulties for diagnosis, especially in the face of an unknown primary neoplasm. Unusual features observed in this series included examples of cutaneous metastatic melanoma that closely simulated metastatic carcinoma, dermatofibroma, leiomyosarcoma, angiosarcoma, nevoid melanoma, halo nevus, blue nevi, and atypical fibroxanthoma. Several cases also showed rhabdoid, balloon cell, and alveolar features. Immunohistochemical stains plus careful clinical history helped to establish the correct diagnosis. Our series illustrates that the differential diagnosis of cutaneous metastatic melanoma can be broad and difficult. To the best of our knowledge, this is the largest series of cutaneous metastatic melanomas reported in the literature.

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Section: Discussionmentioning

confidence: 99%

Cutaneous Metastases of Malignant Melanoma: A Clinicopathologic Study of 192 Cases With Emphasis on the Morphologic Spectrum

Plaza

Torres‐Cabala²,

Evans

et al. 2010

The American Journal of Dermatopathology

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“…59,68 DETECTION OF ANGIOTROPISM As the description by Handley, 46 there have been reports of angiotropism in primary and metastatic melanoma, as detected on histopathologic evaluation. [69][70][71][72][73] Barnhill et al 74 described angiotropism in 36 primary melanomas on H&E-stained tissue sections, as defined by unequivocal cuffing of melanoma cells on the external surface of vessels in a linear array or aggregates in at least two foci at the advancing front of the tumor and without evidence of intravascular tumor cells. Of the 35 cutaneous melanomas studied, most (31) were invasive to anatomic level IV, two to level II, and two to level V; the average tumor thickness was 1.64 mm (range: 0.46-8.25 mm).…”

Section: Extravascular Migratory Metastasis and Angiotropismmentioning

confidence: 99%

Lymphatic invasion and angiotropism in primary cutaneous melanoma

Moy

Duncan

Kraft

2017

Laboratory Investigation

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Access of melanoma cells to the cutaneous vasculature either via lymphatic invasion or angiotropism is a proposed mechanism for metastasis. Lymphatic invasion is believed to be a mechanism by which melanoma cells can disseminate to regional lymph nodes and to distant sites and may be predictive of adverse outcomes. Although it can be detected on hematoxylin-and eosin-stained sections, sensitivity is markedly improved by immunohistochemistry for lymphatic endothelial cells. Multiple studies have reported a significant association between the presence of lymphatic invasion and sentinel lymph node metastasis and survival. More recently, extravascular migratory metastasis has been suggested as another means by which melanoma cells can spread. Angiotropism, the histopathologic correlate of extravascular migratory metastasis, has also been associated with melanoma metastasis and disease recurrence. Although lymphatic invasion and angiotropism are not currently part of routine melanoma reporting, the detection of these attributes using ancillary immunohistochemical stains may be useful in therapeutic planning for patients with melanoma.

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“…In a number of reports over the past 2 decades, the term ''angiotropism'' has referred to the histomorphological finding of melanoma (and other tumor) cells presumably attracted to and closely associated with the periendothelial or abluminal surfaces of microvascular channels. [3][4][5][6][7][8][9][10] As we have previously discussed, we now believe angiotropism to be the microscopic representation of EVMM. 3,4 Accordingly, recent studies have provided evidence that angiotropism in melanoma is an important correlate of metastasis, 3,7,11 especially locoregional metastases such as in transit metastases, 11 and a prognostic factor in cutaneous melanoma.…”

Section: Introductionmentioning

confidence: 99%

Atypical Spitzoid Melanocytic Neoplasms With Angiotropism: A Potential Mechanism of Locoregional Involvement

Barnhill¹,

Kutzner²,

Schmidt³

et al. 2011

The American Journal of Dermatopathology

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Atypical spitzoid melanocytic neoplasms (ASMN) may prove difficult to distinguish microscopically from melanoma, and their biological behavior may be unpredictable. ASMN may result in regional lymph node (LN) metastases and frequent sentinel lymph node (SLN) deposits. Angiotropism and extravascular migratory metastasis may account for locoregional metastases in melanoma and thus may potentially explain such locoregional involvement in ASMN. Nine ASMN with angiotropism from 2006 to 2010 were studied. Angiotropism was defined as melanocytes closely opposed to the external surfaces of microvascular channels without intravasation. There were 5 women and 4 men aged 6-40 (mean 18.7) years with ASMN involving the head and neck (5), the extremities (3), and the trunk (1), and the lesions ranged in diameters from 3.5 to 10 (mean 6.2) mm. Breslow thicknesses ranged from 0.66 to 5.35 (mean 3.21) mm, 5 lesions Clark level IV and 4 level V, and dermal mitotic rates varied from 1 to 5 (mean 2.4) per square millimeter. Despite follow-up of 6 months or less in 4 subjects, 5 patients showed regional tumor spread based on detection of SLN deposits, local recurrence, or clinical satellite and LN metastases. Four of 5 patients (80%) undergoing SLN biopsy showed nodal positivity with 2 SLN deposits of >6 mm. Among 4 patients not having SLN biopsy, 1 patient developed local LN metastases after 2 years. We report for the first time angiotropism in ASMN and suggest that such angiotropism seems to correlate with and may explain regional tumor spread in this neoplastic system.

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Angiotropic Metastatic Malignant Melanoma

Cited by 28 publications

References 0 publications

Cutaneous Metastases of Malignant Melanoma: A Clinicopathologic Study of 192 Cases With Emphasis on the Morphologic Spectrum

Cutaneous Metastases of Malignant Melanoma: A Clinicopathologic Study of 192 Cases With Emphasis on the Morphologic Spectrum

Lymphatic invasion and angiotropism in primary cutaneous melanoma

Atypical Spitzoid Melanocytic Neoplasms With Angiotropism: A Potential Mechanism of Locoregional Involvement

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