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Why do melanomas ulcerate?

J M Mascaro, J Castro, T Castel

    Journal of Cutaneous Pathology
    |August 1, 1984
    PubMed
    Summary
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    Ulceration in malignant melanoma (MM) correlates with higher mitotic activity. This suggests proliferating tumor cells or tumor expansion may cause ulceration, impacting prognosis.

    Area of Science:

    • Oncology
    • Dermatology
    • Pathology

    Background:

    • Ulceration is a known negative prognostic indicator in malignant melanoma (MM).
    • The underlying mechanisms driving melanoma ulceration remain incompletely understood.

    Purpose of the Study:

    • To investigate the potential causes of ulceration in malignant melanoma.
    • To explore the relationship between melanoma ulceration and mitotic index.

    Main Methods:

    • Comparative analysis of 69 ulcerated and 69 non-ulcerated malignant melanomas.
    • Quantification of mitotic figures per 10 high-power fields in tumor samples.

    Main Results:

    • A statistically significant correlation (P < 0.001) was observed between melanoma ulceration and a higher mitotic index.

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  • Ulcerated melanomas predominantly exhibited a high mitotic count (≥7 figures/10 HPF).
  • Conclusions:

    • Melanoma ulceration is likely caused by epidermal destruction from rapidly proliferating neoplastic cells.
    • Tumor expansile activity altering blood supply may also contribute to ulceration.
    • The strong association between ulceration and mitotic activity clarifies its prognostic significance.