Spontaneous Regression of Malignant Melanoma | Spontaneous Remission Database

Abstract

Spontaneous regression of malignant tumours is a rare but well-recognized event. It has been previously reported in malignant melanomas but it must nonetheless still be regarded as an uncommon occurrence. Recent increased interest in the incidence and behavior of malignant melanomas within Australia, and in immunological concepts relating to this condition, have prompted us to report a further case of spontaneous regression. In particular, this related to satellite recurrences following an earlier primary resection. We cannot offer any reason for the remarkable remission which has occurred in this patient, but its occurrence and the time (5 1/2 years) over which the tumour has remained quiescent, seem of sufficient interest to warrant reporting the case.

Case Details

Personal Characteristics

Male, 65 years old

Clinical Characteristics

Dark patch about one inch in diameter appearing on the left cheek just in front of the left ear, surrounded by smaller black nodules. No lymph nodes were palpable and no evidence of distant metastases was present, either clinically or on radiological examination.

Remission Characteristics

The recurrences became worse for about three months after his earlier visits. The nodules became raised above the surface of the skin but did not ulcerate. Thereafter they gradually regressed, becoming flat and much less pigmented. This improvement continued for about nine months and then remained stationary over the subsequent two and a half years before the episode of renal colic.

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Clinical Treatment

Excision biopsy of the main lesion, wide local excision with removal of the scar, adjacent nodules and about 4 centimeters of the surrounding skin. The specimen extended posteriorly to include the tragus of the ear, and in depth included the subcutaneous tissue and the superficial portion of the parotid salivary gland.

Additional Notes

The patient made a satisfactory recovery after operation, but it was decided not to replace the forehead flap until it seemed clear that local cure had been achieved. He remained well for seven months before presenting with a crop of local recurrences on the skin of the cheek adjacent to the line of excision and also involving the upper and lower parts of the flap.