EDITORIAL ESPANOL:

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Saludos amigos del DERMA-CYBER,,, el tema de hoy MELANOMA MALIGNO, NEVUS GIGANTE PIGMENTADO E INVOLUCIÓN. Pueden realmente estos nevus experimentar regresión espontánea. ??? Revisé la literatura y encontré algunas referencias que apoyan estos comentarios. Espero que las disfruten.

En el attach 1 lamina ilustrativa de la referencia No.1 Spontaneous regression of congenital giant ceil pigmented nevus with malignant melanoma,, ...alguien diría por alli "aunque usted no lo crea..."

PRÓXIMA EDICIÓN: LA D-PENICILAMINA , LO BUENO Y LO MALO.

Saludos,,,

Dr. José Lapenta R.,,,

 EDITORIAL ENGLISH:

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Greetings friends of the DERMA-CYBER, today's topic MALIGNANT MELANOMA, PIGMENTED CONGENITAL NEVUS AND REGRESSION. Really can these nevus to experience spontaneous regression. ???. Look for in the literature and I found some references that support these comments. I hope enjoy them. 

In the attach 1 illustrative sheet of the reference No.1) Spontaneous regression of congenital giant cell pigmented nevus with malignant melanoma,,, ...somebody would say... believe it..or not." 

 

NEXT EDITION: THE D-PENICILLAMINE, THE GOOD AND THE BAD.

Greetings,,,

Dr. José Lapenta R. 

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DERMAGIC/EXPRESS(49)

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1.) Spontaneous regression of congenital giant cell pigmented nevus with malignant melanoma (attach file melano.gif)

2.) Pigmentary regression in a giant nevocellular nevus: a case report and a review of the subject. 

3.) Spontaneous resolution of a giant congenital melanocytic nevus. 

4.) Regressing malignant melanoma. 

5.) Spontaneously regressing malignant melanoma with unusual histological features. 

6.) Metastatic malignant melanoma with spontaneous and complete regression of the primary lesion. Case report and review of the literature. 

7.) The many faces of completely regressed malignant melanoma. 

8.) Immune response against human primary malignant melanoma: a distinct cytokine mRNA profile associated with spontaneous regression. 

9.) Double choroidal malignant melanoma in an eye with apparent clinical regression. 

10.) Effect of IFN-alpha on tumor-infiltrating mononuclear cells and

regressive changes in metastatic malignant melanoma. 

11.) Regression of cardiac involvement by malignant melanoma following

lomustine chemotherapy. 

12.) Malignant melanoma risk factors by anatomic site: a case-control study and polychotomous logistic regression analysis. 

13.) Clonal T cell responses in tumor infiltrating lymphocytes from both regressive and progressive regions of primary human malignant melanoma. 

14.) Prognostic factors in thin cutaneous malignant melanoma. 

15.) Histologic regression in malignant melanoma: An interobserver concordance study

16.) Histological regression in malignant melanoma: recognition, incidence and significance (Meeting abstract).

17.) Complete spontaneous regression of cutaneous primary malignant melanoma

18.) Lymph nodes with metastatic melanoma of unknown primary site

19.) Malignant melanoma of the parotid gland

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1.) Spontaneous regression of congenital giant cell pigmented nevus with malignant melanoma

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J.-I. Hasegawa, N. Maeda, T. Kanzaki, N. Mizuno

Departments of Dermatology, Nagoya City University Medical School, Nagoya, Japan

case report:

A 13-year-old Japanese girí was seen with a giant pigmented nevus on her right temple, scalp, neck, upper trunk and right arm, present already at birth (Fig 1). This pigmented nevus gradually faded away by casting off black crusts or scales from the surface over a time span of 13 years (Fig. 2). The black lesion totally flattened and became normal in color leaving several small neurofibroma-like nodules (Fig. 2). At the age of 6 years a nodular black pedunculated tumor 3 cm in diameter de-veloped on her upper back. This proved to be a malignant melanoma histologically. The tumor was excised locally. A recur-rence or metastasis has not been observed since then for 7 years.

Histological findings at birth. 

Two types of histology were observed. One was a compound nevus with irregular acanthosis and hyperkeratosis, and the other a com-pound nevus with neurofibroma-like der-mis. Both of them showed strong junction-al activity and casting off phenomenon (transepidermal elimination). No cellular atypia was observed.

Histological findings at 6 years of age

(malignant melanoma and nevus). 

The malignant melanoma was composed of 2 celí types i. e. spindle and epithelioid celís. The nevus resembled a neurofibroma; there was no junction~ activity what-soever. There are 4 possibilities in the spontaneous regression of nevocellular nevi and malignant melanoma. These are 1) Sutton's phenomenon (4), II) transepi-46 dermal elimination (2), III) neurofibro-matous and IV) fatty degenerations.

Fig. 1. Clinical feature at 4 days oid.

Fig. 2. Giant pigmented nevus regressed at 6 years oíd.

(see the attach)

The spontaneous regression of congeni-tal pigmented nevus of our case is believed to be caused by the transepidermal elimi-nation of nevus celis as reported by Kan-zaki et al. (2).

Many black crusts or scales were sbed from the lesion resulting in clearing of the nevus, as the parents reported. This was supported by the histological examination, which revealed the nevus celís being elimi-nated from the epidermis. The nevus celís in the dermis were replaced by neuro-fibromatous celis in the deeper dermis.

To our best knowledge, tliis is tbe first case which showed complete spontaneous regression of a congenital giant pigmented nevus.

References

1. Copeman PWM, et al. Br J Dermatol 1973; ~ 127

2. Kanzaki T, et al. The l2th International Pigment Ceil Conference. 19~3; p 1(13

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2.) Pigmentary regression in a giant nevocellular nevus: a case report and a review of the subject. 

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ARTICLE SOURCE: Pediatr Dermatol (United States), Aug 1988, 5(3) p178-83 

AUTHOR(S): Zack LD; Stegmeier O; Solomon LM 

PUBLICATION TYPE: JOURNAL ARTICLE; REVIEW (42 references); REVIEW OF REPORTED CASES 

ABSTRACT: A giant congenital nevocytic nevus (CNN) on the trunk was followed in a patient from age three months to 23-years-old. During that time the nevus underwent pigmentary regression leaving 2-3 mm lentigines without any evidence of vitiligo or halo formation around the giant CNN. Histopathologically, nevus cells remained in the dermis. 

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3.) Spontaneous resolution of a giant congenital melanocytic nevus. 

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ARTICLE SOURCE: Pediatr Dermatol (United States), Aug 1988, 5(3) p170-2 

AUTHOR(S): Hogan DJ; Murphy F; Bremner RM 

PUBLICATION TYPE: JOURNAL ARTICLE 

ABSTRACT: This is the second report of a case of spontaneous resolution of a giant congenital melanocytic nevus, which was documented both by photographs and skin biopsies. Cases of spontaneous resolution of these lesions may represent a vigorous host response against an aberrant clone of melanocytes. 

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4.) Regressing malignant melanoma. 

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Author 

Grafton WD 

Address 

Louisiana State University School of Medicine, Shreveport 71130. 

Source 

J La State Med Soc, 146(12):535-9 1994 Dec 

Abstract 

Malignant melanoma may undergo spontaneous regression. This phenomenon

may

cause difficulty in clinical or pathologic diagnosis. The cases

reported in the literature as

complete spontaneous regression of primary malignant melanomas have been

diagnosed only in retrospect, after the patient presented with

metastatic malignant

melanoma. Two cases of malignant melanoma with partial regression are

reported. In

these cases the areas of complete regression cannot be recognized as

malignant

melanoma. The definitive diagnosis of malignant melanoma can be made

only in the

areas with at least two of three characteristic features of melanoma,

(1) melanocytic cells

with atypical nuclei and prominent nucleoli, (2) mitoses in

melanocytic cells, and (3) invasion

of the epidermis by atypical melanocytic cells. Clinical features

suggesting regressing

malignant melanoma include changes in color, especially areas of

depigmentation,

variations in color in different areas of a pigmented mole, and

decrease in size of a mole.

Histopathologic features of regression include loss of melanin pigment

from the epidermis,

melanophages in the dermis, telangiectasia of capillaries in the

dermis, and lymphocytic

infiltration in the dermis in a band-like or perivascular pattern.

These histologic findings may

also be found in inflammatory lesions such as lichen planus and in

regressing benign

melanocytic nevi. 

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5.) Spontaneously regressing malignant melanoma with unusual histological features. 

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Author 

Tamura A; Ishikawa O; Miyachi Y 

Address 

Department of Dermatology, Gunma University School of Medicine, Japan. 

Source 

Acta Derm Venereol, 74(6):451-3 1994 Nov 

Abstract 

An 85-year-old man with spontaneously regressing primary malignant

melanoma is

reported. Histological features were considered to be compatible with

those of

spontaneously regressing malignant melanoma, except that many

multinucleated giant

cells were observed replacing typical melanoma cells. 

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6.) Metastatic malignant melanoma with spontaneous and complete regression of the primary lesion. Case report and review of the literature. 

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Author 

Shai A; Avinoach I; Sagi A 

Address 

Department of Plastic and Reconstructive Surgery, Soroka University

Hospital, Faculty of

Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. 

Source 

J Dermatol Surg Oncol, 20(5):342-5 1994 May 

Abstract 

BACKGROUND. Spontaneous regression of malignant melanoma is

characterized by

a partial or complete disappearance of the neoplasm. Partial

regression of melanoma has

been documented in large series, but complete regression is reported

as occurring only

sporadically. OBJECTIVE. To describe a case of metastatic malignant

melanoma

where the primary lesion underwent spontaneous and complete regression

and to review

the literature pertaining to regression of melanoma. METHODS. The

patient was

examined clinically. Wide excision of the skin with the lesion was

performed as well as left

inguinal lymph node dissection. RESULTS. Histologic examination of the

lesion revealed

complete regression of malignant melanoma. Examination of the lymph

node dissected

from the adjacent inguinal area revealed matastatic melanoma.

CONCLUSIONS. Greater

attention should be devoted to identification of regression in

melanoma, clinically and

histologically, evaluating the prognostic implications which

regression might indicate. 

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7.) The many faces of completely regressed malignant melanoma. 

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Author 

Barr RJ 

Address 

University of California, Irvine, USA. 

Source 

Pathology (Phila), 2(2):359-70 1994 

Abstract 

The prognostic significance of clinical and histologic regression of

malignant melanoma

is highly controversial. Although small foci of regression in evolving

malignant

melanomas seem to have little or no effect on morbidity and mortality,

extensive regression

in larger, fully evolved lesions may be associated with poor

prognosis. This chapter

emphasizes the histologic features of regression and the patterns that

are responsible for

diagnostic pitfalls. 

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8.) Immune response against human primary malignant melanoma: a distinct cytokine mRNA profile associated with spontaneous regression. 

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Author 

Wagner SN; Schultewolter T; Wagner C; Briedigkeit L; Becker JC;

Kwasnicka HM;

Goos M 

Address 

Department of Dermatology, University of Essen, Germany. 

Source 

Lab Invest, 78(5):541-50 1998 May 

Abstract 

Spontaneous regression of melanoma lesions is thought to be the result

of an efficient

immune response against melanoma cells in vivo. The outcome of immune

responses is

critically influenced by a complex network of interacting cytokines

present in the local

microenvironment. Analysis of cytokine gene transcription in melanoma

lesions exhibiting

or lacking a sufficient anti-tumor immune response thus may help to

define cytokines or

cytokine combinations critical to the development of this immune

response. In the present

study, we have investigated an extended panel of cytokine and cytokine

receptor genes by

reverse transcription-PCR and in situ hybridization in regressive and

progressive primary

human cutaneous melanoma samples. Whereas the presence of a lymphocyte

infiltrate in

tissue samples was associated with a TH1 cytokine mRNA profile

(TNF-alpha,

INF-gamma, IL12p35, IL12p40, IL2Rbeta, and IL2Rgamma), clinically and

histologically

regressive samples exhibited additionally increased transcript levels

for GM-CSF, IL2, and

IL15. mRNAs of TH2 cytokines IL4 and IL5 were detected only in a minor

portion of

progressive melanoma samples and regressive melanoma lesions. These

results were

further supported by comparison of progressive with regressive regions

in three

melanoma samples. Again, regressive regions contained higher

transcript levels for

GM-CSF, IL2, and IL15. In comparison to cutaneous metastatic melanoma

lesions,

regressive melanomas also overexpressed the same cytokine mRNA

profile. These

results provide evidence for an association of spontaneous regression

with increased

transcript levels for the cytokine combination GM-CSF, IL2, and IL15

in malignant

melanoma. This cytokine combination could be relevant for experimental

anti-tumor

immune response studies and for immunotherapeutic and gene transfer

studies in the

treatment of melanoma patients. 

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9.) Double choroidal malignant melanoma in an eye with apparent clinical regression. 

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Author 

Holck DE; Dutton JJ; Pendergast SD; Klintworth GK 

Address 

Department of Ophthalmology, Wilford Hall Medical Center, San Antonio,

Texas 78236,

USA. 

Source 

Surv Ophthalmol, 42(5):441-8 1998 Mar-Apr 

Abstract 

Multicentric melanomas in the same eye are rare, with few cases

substantiated by

histology and serial sectioning. We report a patient with two

documented choroidal

malignant melanomas in one eye. The initial tumor spontaneously

decreased in size for

over 2 years before a second tumor appeared in a noncontiguous

location in the same eye.

After enucleation, serial sections showed that the two lesions were

independent choroidal

melanomas. We review the literature regarding multiple, independent

intraocular choroidal

malignant melanomas. 

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10.) Effect of IFN-alpha on tumor-infiltrating mononuclear cells and

regressive changes in metastatic malignant melanoma. 

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Author 

H akansson A; Gustafsson B; Krysander L; H akansson L 

Address 

Department of Oncology, University Hospital, Link¨oping, Sweden. 

Source 

J Interferon Cytokine Res, 18(1):33-9 1998 Jan 

Abstract 

Interferon-alpha (INF-alpha) has a documented activity against

metastatic melanoma. To

what extent an antiproliferative effect or tumor cell modulation or

immunomodulation

contributes to this antitumor effect is still uncertain. The role of

immune mechanisms in the

control of malignant melanoma is suggested by several studies.

Therefore, this

investigation used monoclonal antibodies, anti-CD4, anti-CD8, and

anti-CD11c, to study

the occurrence and distribution of tumor-infiltrating mononuclear

cells in 10 untreated and

26 IFN-alpha-treated patients with regional metastatic malignant

melanoma. IFN-alpha

was given for 1-3 weeks before resection of the metastases. The

infiltration of mononuclear

cells in the stroma and close to tumor cells was studied. The duration

of IFN-alpha

treatment was found to be of importance for the immunomodulatory

effect. In patients

treated for < or = 1 week, tumor-infiltrating mononuclear cells were

still mainly localized in

the stroma, similar to the situation in untreated patients. The

differences in CD4+ cells close

to the tumor cells, comparing untreated patients and patients with

various durations of

IFN-alpha treatment, were highly significant (p = 0.009). Thus,

IFN-alpha treatment

resulted in recruitment of CD4+ cells close to the tumor cells.

IFN-alpha had only a weak

effect on the recruitment of CD8+ and CD11c+ mononuclear cells close

to the tumor cells.

Regressive changes in metastases were also analyzed and correlated to

duration of

treatment. Some of the criteria used for histopathologic regression in

primary melanoma

(distorted histologic architecture, low tumor cell density, and

fibrosis) were applied to

analyze the effect of IFN-alpha in metastatic melanoma. The tumor cell

density was found

to be significantly reduced in metastases with marked tumor regression

compared with

metastases with no, or only minor, regressive changes (p < 0.005). A

chi-square analysis

for trend, comparing untreated patients and patients with various

durations of IFN-alpha

treatment, showed that regressive changes of the tumor increased

significantly during

IFN-alpha treatment (p = 0.02). 

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11.) Regression of cardiac involvement by malignant melanoma following

lomustine chemotherapy. 

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Author 

Carpenter MR; Vassallo M; Peat IM; Scriven AJ 

Address 

Department of Cardiology, Leicester General Hospital, UK. 

Source 

Postgrad Med J, 73(863):571-2 1997 Sep 

Abstract 

Cardiac involvement by malignant melanoma is usually a premorbid

event. We present a

case of presumed cardiac involvement by malignant melanoma with

regression

following chemotherapy as demonstrated by transoesophageal

echocardiography. 

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12.) Malignant melanoma risk factors by anatomic site: a case-control study and polychotomous logistic regression analysis. 

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Author 

Chen YT; Dubrow R; Holford TR; Zheng T; Barnhill RL; Fine J; Berwick M 

Address 

Department of Epidemiology and Public Health, Yale University School

of Medicine, New

Haven, CT 06520-8034, USA. 

Source 

Int J Cancer, 67(5):636-43 1996 Sep 4 

Abstract 

This population-based case-control study systematically examined

reported malignant

melanoma risk factors by anatomic site. Study subjects consisted of

548 invasive

melanoma cases diagnosed in Connecticut during 1987-1989 and 494

randomly selected

controls. Multivariate polychotomous logistic regression was used to

determine whether

risk factors differed across anatomic sites. Risk factors examined

included demographic

and pigmentary characteristics, sun exposure-related factors, anatomic

site-specific

sunburn, recreational water activity clothing habits and number of

nevi. A pattern of

site-specificity was observed for sunburn. A history of sunburn at an

anatomic site was

specifically related to the development of malignant melanoma at that

site more so than

at other sites. This site-specificity was consistent with a direct

role for intense, intermittent

sun exposure in the development of melanoma. Age and gender were the

only risk factors

that differed significantly in effect across anatomic sites. The age

difference was explained

by differences in histologic subtype across sites. The gender

difference could not be

explained by sex differences in anatomic site-specific sunburns or in

recreational water

activity clothing habits. Alternative explanations include sex

differences in behavioral

patterns of sun exposure that we did not measure and as yet

unelucidated differences in

susceptibility to melanoma according to sex and anatomic site. 

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13.) Clonal T cell responses in tumor infiltrating lymphocytes from both regressive and progressive regions of primary human malignant melanoma. 

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Author 

thor Straten P; Becker JC; Seremet T; Br¨ocker EB; Zeuthen J 

Address 

Department of Tumor Cell Biology, Division of Cancer Biology, Danish

Cancer Society,

Copenhagen, Denmark. 

Source 

J Clin Invest, 98(2):279-84 1996 Jul 15 

Abstract 

The T cell receptor (TCR) BV variable (V) gene repertoire of tumor

infiltrating lymphocytes

(TIL) found in progressive and regressive regions of the same primary

human melanomas

were characterized by reverse transcription coupled polymerase chain

reaction (RT-PCR).

After surgery, the tumors were divided into different parts which were

judged as regressive

or progressive regions by visual inspection. Subsequently this

diagnosis was confirmed by

histology. From a total of four primary melanomas analyzed, 2 were

drawn to be

HLA-A2+. Only relatively few BV-gene families were expressed at

significant levels in

each of the samples. Comparison of the BV-expression in regressive

versus progressive

regions of the same tumor revealed major differences in all cases

examined. Direct

sequencing of RT-PCR products indicated that highly expressed BV-gene

families were of

clonal origin in both the regressive and progressive regions.

Together, these data strongly

suggest the occurrence of clonal T cell responses in both regressive

and progressive areas

of the same primary tumor. The differences in expression of certain

BV-genes may

correlate with the functional activity of certain populations of

tumor-infiltrating T cells. 

Complete regression of primary cutaneous malignant melanoma. 

Author 

Menzies SW; McCarthy WH 

Address 

Department of Surgery, Sydney Melanoma Unit, University of Sydney,

Camperdown,

Australia. 

Source 

Arch Surg, 132(5):553-6 1997 May 

Abstract 

While partial spontaneous histopathological regression is a common

finding in invasive

primary melanoma, proven complete regression is rare, with only 33

cases having been

documented. None of the patients in these reported cases had a biopsy

specimen taken

from the original lesion, which would unequivocally prove the

diagnosis of complete

regressing melanoma. Over 4 years, we saw a 62-year-old white man who

refused

treatment of a biopsy specimen-proved superficial spreading melanoma

(Breslow

thickness, 0.7 mm) that eventually regressed completely. A biopsy

specimen confirmed

complete histopathological regression. There was no clinical evidence

of regional or distant

metastases throughout the 4 years. To our knowledge, this is the first

documented case of a

biopsy specimen-proved primary melanoma completely regressing. We present

sequential photographic documentation and review the literature about

this phenomenon.

While the prevalence of such an event is unknown, evidence is

presented that it may be

more common than previously thought. 

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14.) Prognostic factors in thin cutaneous malignant melanoma. 

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Author 

M ansson-Brahme E; Carstensen J; Erhardt K; Lagerl¨of B; Ringborg U;

Rutqvist LE 

Address 

Department of Oncology, Radiumhemmet, Karolinska Hospital, Stockholm,

Sweden. 

Source 

Cancer, 73(9):2324-32 1994 May 1 

Abstract 

BACKGROUND. Thin melanomas can metastasize and be lethal. The predictive

importance of tumor thickness in thin melanomas and the specific

features identifying the

patients at risk have not been investigated fully. METHODS. Prognostic

factors were

analyzed in 585 patients with clinical Stage I invasive cutaneous

malignant melanoma

with a thickness of less than or equal to 0.8 mm. The patients were

included in a

population-based cancer registry in Stockholm county during 1976-1987.

They constituted

about 64% of all patients with thin melanomas who were diagnosed in

the region during

the study period. Information was available on age, sex, anatomic site

of the tumor,

histologic type of melanoma, level of invasion, tumor thickness, and

tumor regression. In

a Cox regression analysis, the prognostic importance of each factor

was studied. By a

case-control technique with individual matching for the identified

independent predictors of

recurrence, the additional prognostic information given by type and

grade of inflammatory

response, presence of vertical growth phase, mitotic rate/mm2, and

histologic ulceration of

the tumor was assessed. RESULTS. After a median follow-up time of 50

months, recurrent

disease developed in 26 patients (4%). There was no difference in

recurrence rate between

patients treated with narrow (1-2 cm) or wide (5 cm) excision.

Anatomic site, tumor

thickness, level of invasion, and tumor regression were found to be

independent prognostic

factors in the multivariate analysis. In the case-control study, only

grade of inflammatory

reaction added significant prognostic information. No subgroup could

be identified that was

without risk of recurrent disease. CONCLUSIONS. Thin melanomas do not

seem to

constitute a separate form of melanoma, but compose one end of a

continuous spectrum

of biologic behavior. 

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15.) Histologic regression in malignant melanoma: An interobserver concordance study

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AU: Kang-S; Barnhill-RL; Mihm-MC Jr; Sober-AJ

SO: J-Cutan-Pathol. 20(2):126-9 1993

PY: 1993

PT: JOURNAL-ARTICLE

AB-A: Histologic evidence for regression as a prognostic indicator in melanoma has shown conflicting results. To assess if melanoma regression is a consistently identifiable histologic feature, an interobserver concordance study was undertaken. Fifty histologic slides of melanoma with Breslow thickness of 1 mm or less were non-randomly selected from the Massachusetts General Hospital Melanoma Registry. The selection was in favor of those with regression present in 44 of 50 slides (88%). Two dermatopathologists working independently evaluated a 2 mm wide bracketed area in each tissue section and then the remainder of the non-bracketed tissue section for regression. Before and after each slide review, the evaluators were required to read criteria for early, intermediate, and late regression explicitly outlined. The overall concordance rate for the presence and absence of regression was 96% (48/50) in the bracketed area and 90% for the outside area. When the group with regression was subdivided into three stages, interobserver agreement fell to 86% for the bracketed, and 66% for the outside area. In at least 30% of cases where regression was detected in the bracketed area, both reviewers observed two or more stages of regression in the remainder of tissue section. Therefore, subdividing the process is impractical and unrealistic. Consistent histologic identification of regression in melanoma requires a simple and systematic approach which should be applied to future studies that include melanoma regression as a prognostic factor. (Abstract from CANCERLIT AND EMBASE)

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16.) Histological regression in malignant melanoma: recognition, incidence and significance (Meeting abstract).

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AU: Blessing-K; McLaren-KM

SO: J-Pathol. 167(Suppl):162A 1992

PY: 1992

PT: MEETING-ABSTRACT

AB-A: The phenomenon of tumor regression presents a potentially dramatic demonstration in favor of a role for host immunity. Although complete regression in melanoma is rare, partial regression is relatively common; however, there is a wide range of reported incidence, most of which can be explained by differences in criteria for definition of the process. The clinical significance of regression in melanoma also remains unresolved. From the Department of Pathology in Aberdeen, 563 cases of primary melanoma (from a 20-yr period) were assessed for the presence of histological regression, in association with the thickness of the lesion, patient sex, anatomical location and clinical outcome. The extent of lesional regression was assessed semiquantitatively. Regression was more commonly found in thin lesions, being seen in 46% of thin (less than 1.5 mm) lesions, 32% of intermediate (1.5-3.0 mm) lesions and 9% of thick (greater than 3.0 mm) lesions. However, severe regression was only identified in 6.5% of thin lesions, 5.2% of intermediate lesions and 1.5% of thick melanomas. Regression was more common in superficial spreading melanomas and in lesions from the trunk and lower limb, with it being seen slightly more often in men. Clinical follow-up, although not of statistical significance, suggests that regression in thin lesions is a sinister histological feature, supporting results from other centers. (Abstract from CANCERLIT)

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17.) Complete spontaneous regression of cutaneous primary malignant melanoma

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AU: Bottger-D; Dowden-RV; Kay-PP

SO: PLAST-RECONSTR-SURG. 89/3 (548-553) 1992

PY: 1992

PT: Journal-Article

AB-A: Melanomas may first present as nodal metastasis. Most of these cases have a discernible primary source. A proportion of these, however, have no apparent primary. A very few patients in this latter group actually have an identifiable primary source that regressed and disappeared. There is a set of stringent clinical and histologic criteria that must be met before a melanoma can be classified as complete spontaneous regression, and only 24 cases in the literature meet all these criteria. This report reviews those cases and presents the first report to provide sequential photographic documentation of a complete spontaneous regression of a cutaneous malignant melanoma. It also gives a 10-year follow-up, the longest in the literature. (Abstract from EMBASE)

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18.) Lymph nodes with metastatic melanoma of unknown primary site

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AU: Nguyen-T; Avril-MF; Charpentier-P; Guillaume-C; Margulis-A; Prade-M

SO: Bull-Cancer-Paris. 79(3):291-6 1992

PY: 1992

PT: JOURNAL-ARTICLE; REVIEW; REVIEW,-MULTICASE

AB-A: Sixteen patients with clinical stage II melanoma of unknown primary site (regional lymph node metastasis) were followed up between 1978 and 1988. The 5-year survival rate was 47%. These results seem to parallel those for stage II disease with known primary tumor sites, as has been observed in other data from the literature. The hypotheses put forward to explain such lesions are the spontaneous regression of the primary tumor, and the onset of primary malignant melanoma in the lymph nodes. (30 Refs) (Abstract from CANCERLIT AND EMBASE)

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19.) Malignant melanoma of the parotid gland

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AU: Roberts-C; Jayaramachandran-S

SO: Br-J-Clin-Pract. 46(3):217-8 1992

PY: 1992

PT: JOURNAL-ARTICLE

AB-A: We report a case which demonstrates pitfalls in the management of a parotid gland s and highlights behaviour of malignant melanoma that is not widely appreciated. The danger of assuming a benign histological diagnosis of such a mass and the subsequent delay of definitive surgery is demonstrated. Metastases within the parotid gland are not uncommon, melanoma being one of the commonest sources. A search should always be made for a primary tumour in the head, neck and chest. This can be made exceptionally difficult by the uncommon phenomenon of spontaneous regression of the primary melanoma. (Abstract from CANCERLIT AND EMBASE)

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DATA-MÉDICOS/DERMAGIC-EXPRESS No (49) 14/04/99 DR. JOSE LAPENTA R. 

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Produced by Dr. José Lapenta R. Dermatologist

Venezuela 1.998-2.024

Producido por Dr. José Lapenta R. Dermatólogo
Venezuela 1.998-2.024

Tlf: 0414-2976087 - 04127766810