Definition Of Vertical Growth Phase Melanoma

Although a direct correlation between these two parameters in individual cases seems to be lacking it is clear that metastasis is invariably preceded by angiogenesis. Comparison of metastatic melanoma cells with cells of the vertical growth phase vgp or late primary melanoma from the same individual revealed generally a shorter population doubling time growth to a higher cell density higher tyrosinase activity and more pigmentation in metastatic cells. If a pathology report has a depth but says nothing about growth phase it is assumed to be vertical.

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Most melanomas have an initial radial growth phase within the epidermis and sometimes within the papillary dermis figure 1 2 which may be followed by a vertical growth phase with deeper extension figures 3 4.

Definition of vertical growth phase melanoma. Vertical growth phase vgp. Therefore the tumor often is deeper at the time of diagnosis and as a result has a poorer prognosis. At this point it s called melanoma with competence for metastasis or the vertical growth phase. Instead of having a horizontal growth phase like a superficial spreading malignant melanoma this has a quicker vertical growth phase meaning that the tumor invades the dermis at a faster rate.

Vertical growth phase defines tumours that are characterised by a nodule or plaque filling the papillary dermis with or without extension into the reticular dermis fig 2b. Erhard h 1 rietveld fj van altena mc bröcker eb ruiter dj de waal rm. If present it is an indication that the melanoma is growing vertically or deeper into the tissues. Vertical growth phase vgp melanoma in contrast is characterized by the essential feature of tumor nodule formation figure 1 c.

The aims of the study were to evaluate agreement between nonspecialist pathologists in identifying the vertical growth phase in malignant melanoma and to compare agreement for the growth phase. It s not universally accepted. Melanoma progression in general is characterized by an increase in both metastatic frequency and the vascular density of the tumour tissue. Transition of horizontal to vertical growth phase melanoma is accompanied by induction of vascular endothelial growth factor expression and angiogenesis.

Cellular heterogeneity in vertical growth phase melanoma. But the research that does exist shows the radial growth lesions with a depth have a prognosis more consistent with in situ than invasive melanoma. Melanoma may arise de novo or within an existing benign or dysplastic naevus. Differences between dermal and epidermal melanocytes are easy to determine and mitotic figures can be identified.

1997 aug 7 suppl 2 s19 26. Vgp melanomas are invasive and have a potential to metastasize spread to other areas. The melanoma is described as having vgp present or absent.