The significance of blood flow in cutaneous malignant melanoma demonstrated by Doppler flowmetry

Abstract

The vascularity of malignant melanoma has been studied in 23 patients by Doppler ultrasonic frequency shift recordings. A 10 or 8 MHz directional Doppler probe was used and the signals were analysed on an Angioscan II spectrum analyser. No blood flow was detected in 7 primary melanomas each of thickness less than 0.75 mm and one recurrent subcutaneous nodule. Abnormal blood flow signals were detected in 8 primary melanomas--each of thickness greater than 1.2 mm--and in 7 skin nodules of secondary melanoma. Three tumours did not conform to the general pattern--one primary tumour 0.7 mm thick had abnormal blood flow signals whereas one primary lesion of 2 mm thickness and one secondary deposit were flow negative. Thus neovascularization corresponds in general to the cut-off point for good prognostic tumours, suggesting that it is a development of biological significance. This vascular pattern can be detected non-invasively by means of a Doppler probe and may have a prognostic importance, particularly with melanomas of the intermediate thickness range of 0.75-3.0 mm, where precise outcome cannot at present be predicted. The significance of an abnormal blood flow in one thin tumour remains to be determined from long-term follow-up.