Physiopathological mechanisms and morphological parameters involved in the progression of cutaneous melanoma

Abstract

Objective: To analyze the associations between clinical and histopathological parameters in cutaneous melanoma from a single-center perspective.

Methods: We conducted a retrospective analytical study including melanoma cases diagnosed in the Pathology Department of the Clinical County Hospital Mureș, Romania, over two years. The cohort included both primary tumors and metastases.

Results: The study included 49 cases (30 primary tumors and 19 metastases). Primary melanoma was more frequent in men (mean age 65.2 years), predominantly located on the trunk. Nodular melanoma was the most common subtype (24 cases) and was associated with higher Clark levels (p = 0.0015), increased Breslow thickness (p = 0.007), and ulceration (18 cases, p = 0.025), without a significant association with metastasis. Ulceration was associated with increased Breslow thickness (p = 0.018) and older patient age (p = 0.002). Ki-67 and mitotic rate were significantly associated with Breslow thickness, Clark level, and ulceration (p < 0.05). Metastases were more frequent in women (mean age 66 years), mainly involving inguinal and axillary lymph nodes. A significant association was observed between primary tumor location and lymph node metastasis distribution (p = 0.034).

Conclusions: Melanoma progression is associated with morphological parameters reflecting tumor biology and invasion. Routine histopathological markers, including Breslow thickness, ulceration, mitotic rate, and Ki-67, remain essential for prognostic assessment and risk stratification.