Malignant Melanomas; A Clinical Study | Spontaneous Remission Database

Abstract

Thirty-five case reports are presented along with a description of the treatment procedures used. A number of conclusions based upon the discussions of patient case histories is reported. The prognosis in malignant melanoma is very poor. However, a few patients can be cured by adequate surgery. There is a high incidence of malignant melanomas on the lower extremities, and they represent more than half of the malignant tumors of the skin in this region. Malignant melanomas arise in congenital pigmented nevi or as spontaneous primary growths. They rarely arise in pigmented, hairy nevi. Trauma to a pre-existing lesion is probably a factor in stimulation of lawless growth. Cauterization or desiccation is dangerous. Metastases may occur through the skin lymphatics or the deep lymphatics or via the blood stream. Adequate surgical treatment includes wide local removal and thorough dissection of the regional nodes. We realize that the latter procedure is not always feasible. In malignant melanomas of the eye, enucleation is adequate treatment. Roentgen therapy is extremely unsatisfactory, but rarely there is benefit. It should be considered in inoperable cases. Spontaneous regression may occur in the metastases. While the prognosis is particularly poor in cases with regional lymph-node involvement, an occasional cure may be obtained. Patients should be given the benefit of adequate regional dissection.

Case Details

Personal Characteristics

A 43-year-old man

Clinical Characteristics

Had the 5th toe removed for a “black tumor.” an inguinal dissection had been done. Several months before admission he had had erysipelas of the lower leg, followed by the appearance of black nodules. Multiple nodules were found over the lower leg, and there was a fixed mass in the groin but no nodules above the operative area. The masses in the thigh began to disappear, leaving only the pigment. The masses in the thigh finally disappeared, and the patient died of probable brain metastases 6 years after his first admission.

Remission Characteristics

The masses in the thigh began to disappear, leaving only the pigment. The masses in the thigh finally disappeared

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Clinical Treatment

Had the 5th toe removed for a “black tumor.” an inguinal dissection had been done. In malignant melanomas of the eye, enucleation is adequate treatment.

Additional Notes

The case was considered inoperable and no treatment was given. A year later the patient died of probable brain metastases 6 years after his first admission.