title: Lymphatic and blood vasculature in primary cutaneous melanomas of the scalp and neck.
abstract: BACKGROUND
  Scalp/neck melanomas have a poor prognosis, possibly because of a rich vascular supply that prompts tumor cells' dissemination.
  
  
  METHODS
  We compared the accuracy of immunohistochemical (IHC) staining with morphology for the identification of lymphovascular invasion in 156 scalp/neck melanomas. We then analyzed the association of vessel invasion and density with pathological features and survival.
  
  
  RESULTS
  IHC-detected lymphatic vessel invasion (LVI) and blood vessel invasion (BVI) were identified in 34.6% and 13.5% of cases, respectively. IHC increased the LVI/BVI detection compared to morphology (40.4% vs 16.6%; p < .001). The degree of peritumoral and intratumoral blood vessel density (BVD) was greater than lymphatic vessel density (LVD). Ulceration was the only factor independently associated with intratumoral (p = .029) and peritumoral (p = .047) BVD. Tumor thickness was the only independent predictor of survival (p = .002).
  
  
  CONCLUSIONS
  IHC allows accurate assessment of lymphovascular invasion in scalp/neck melanomas. In these tumors, we observed a high incidence of BVI, which deserves further investigations.
authors.affiliation: Melanoma and Sarcomas Unit, Veneto Institute of Oncology, Padova, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Pasquali
authors.affiliation: Pathology Unit, Veneto Institute of Oncology, Padova, Italy.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Montesco
authors.affiliation: S. Maria Annunziata Hospital, Firenze, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Ginanneschi
authors.affiliation: University of Firenze, Firenze, Italy.
authors.forename: Gianna
authors.initials: G
authors.lastname: Baroni
authors.affiliation: University of Siena, Siena, Italy.
authors.forename: Clelia
authors.initials: C
authors.lastname: Miracco
authors.affiliation: S. Maria Annunziata Hospital, Firenze, Italy.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Urso
authors.affiliation: "Di Venere" and "San Paolo" Hospital, Bari, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Mele
authors.affiliation: Azienda Ospedaliera Rimini, Rimini, Italy.
authors.forename: Anna Rita
authors.initials: AR
authors.lastname: Lombardi
authors.affiliation: University of Torino, Torino, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Quaglino
authors.affiliation: Riuniti Hospitals, Bergamo, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Cattaneo
authors.affiliation: University "Federico II" of Napoli, Napoli, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Staibano
authors.affiliation: National Cancer Institute "Pascale,", Napoli, Italy.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Botti
authors.affiliation: National Cancer Institute "Regina Elena,", Roma, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Visca
authors.affiliation: Azienda Ospedaliero Universitaria Integrata Verona, Verona, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Zannoni
authors.affiliation: University "La Sapienza,", Roma, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Soda
authors.affiliation: Policlinico S. Orsola Malpighi, Bologna, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Corti
authors.affiliation: University of Cagliari, Cagliari, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Pilloni
authors.affiliation: P.A. Micone Hospital, Genova, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Anselmi
authors.affiliation: University of Sassari, Sassari, Italy.
authors.forename: Amelia
authors.initials: A
authors.lastname: Lissia
authors.affiliation: University of Firenze, Firenze, Italy.
authors.forename: Margherita
authors.initials: M
authors.lastname: Vannucchi
authors.affiliation: G. Brotzu Hospital, Cagliari, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Manieli
authors.affiliation: University of Firenze, Firenze, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Massi
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001707:Biopsy, Needle; D001808:Blood Vessels / Q000473:pathology*; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D042601:Lymphatic Vessels / Q000473:pathology*; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology*; D008875:Middle Aged; D009333:Neck / Q000098:blood supply / Q000473:pathology; D009389:Neovascularization, Pathologic / Q000503:physiopathology*; D011379:Prognosis; D012189:Retrospective Studies; D012535:Scalp / Q000098:blood supply / Q000473:pathology; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology*; D016019:Survival Analysis; D000096142:Cutaneous Malignant Melanoma
keywords: blood vessel density; blood vessel invasion; cutaneous melanoma; head and neck; lymphatic vessel density; lymphatic vessels invasion; scalp and neck