Complete Spontaneous Regression Of A Metastatic Melanoma Of The Mandible: A Case Report And Follow-up Recommendations
Schlabe, J., Shah, K. A., Sheerin, F., Payne, M. J., & Fasanmade, A. A. (2018). Complete spontaneous regression of a metastatic melanoma of the mandible: a case report and follow-up recommendations. International journal of oral and maxillofacial surgery, 47(12), 1519–1522. https://doi.org/10.1016/j.ijom.2018.06.007
View Original Source →Abstract
Regression of metastatic melanoma is very rare and occurs in only 0.23% of cases. Metastasis to the oral cavity is particularly uncommon and accounts for only 1-3% of all oral malignancies. This report presents a case of spontaneous and complete regression of a metastatic melanoma in the mandibular ramus. The patient remains asymptomatic more than 2 years after diagnosis. The patient was followed up regularly. It is recommended that further surveillance imaging be performed in asymptomatic patients following discussion with the surgical and oncological teams. This type of surveillance, together with new systemic treatments, is advocated due to its potential to increase long-term survival even after relapse.
Case Details
Disease Location
Mandible, skin
Personal Characteristics
75-year-old white male
Clinical Characteristics
Presented with a left mandibular mass. CT and MRI revealed a large tumour in the left mandibular ramus. Pathological analysis uncovered nested malignant cells with numerous mitoses. Cells were positive for s100 and CD56. To identify the primary tumour, a pigmented irregular-shaped nevus on the left chest was excised and identified as a superficial spreading melanoma within a severely dysplastic compound nevus. However, no convincing invasion was identified. It remains unclear whether this was the primary tumour. During preparation for surgical removal and before treatment was carried out, the tumour shrunk rapidly
Remission Characteristics
A CT scan and a further ultrasound-guided biopsy of the previously affected region revealed no malignancy. MRI and fdg-PET at 3 months after regression revealed no radio- logical evidence of tumour recurrence.
Treatment & Mechanisms
Proposed Remission Mechanisms
Immunological response elicited by biopsy-related surgical trauma.
Clinical Treatment
Biopsy