Spontaneous Regression Of Metastatic Malignant Melanoma
Clinical Oncology 5(1): Mar 1979; 91-92
View Original Source →Abstract
A case is reported in which recurring epithelial cancer disappeared after an attack of erysipelas. The case is reported without special comments, since Dr. Coley has written on this subject in considerable detail. The author comments that he is aware that a single case from the practice of a surgeon is but of little value, isolated and alone, but it is hoped that it will stimulate others to add their experience and observations.
Case Details
Personal Characteristics
A 37-year-old male
Clinical Characteristics
The metastases occurred in multiple organ systems (cerebral, intestinal and distant lymphatic ) and were histologically documented. The patient was first seen in june, 1957 with a skin lesion on the right forearm. Histology revealed malignant melanoma. Dissection of the axillary nodes was carried out but secondary deposits were not encountered. In september, 1958 the patient was operated for a space-occupying mass in the left occipital lobe. Microscopy showed malignant melanoma. The patient then received palliative irradiation to the entire brain (30 x 100 rad, 250 kv). In august, 1960 a laparotomy was performed because of abdominal distress. A large tumour was detected in the jejunum, whereas the mesentery exhibited many macroscopically involved nodes. The small bowel mass was resected with end-to-end anastomosis. One of the nodes was removed separately. The resected tumor contained metastatic malignant melanoma; in the attached mesentery two nodes evidenced secondary melanoma. The separate node biopsy also showed metastatic involvement. Wound healing was considerably delayed because of wound infection. In august, 1962 a thorough neurological evaluation failed to disclose evidence of cerebral recurrence. Four months later the patient was re-admitted for an ill-defined lump in the scar of the previous laparotomy. A second exploratory laparotomy was performed. However, careful examination of the abdomen failed to reveal macroscopic evidence of metastatic disease. Several biopsies were taken but no residual tumor was detected.
Remission Characteristics
The patient has been free of disease for more than 15 years
Treatment & Mechanisms
Proposed Remission Mechanisms
Not discussed
Clinical Treatment
Dissection of the axillary nodes, operation for a space-occupying mass in the left occipital lobe, palliative irradiation to the entire brain, laparotomy, resection of the small bowel mass with end-to-end anastomosis, node removal, second exploratory laparotomy
Additional Notes
The observation that this patient has been free of disease for more than 15 years might constitute spontaneous cure. However, statements about natural ‘cures’ for metastatic melanoma should be viewed with scepticism since several cases reported in the literature eventually have died of their disease, even after 5 to 10 years of apparent remissions.