Spontaneous Regression of a Malignant Melanoma

Levison, V. B.

doi:10.1136/bmj.1.4911.458

Cited by 22 publications

(7 citation statements)

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“…A review by Kalialis et al recovered only 76 cases from the literature since 1866, which corresponds to an incidence of 0.23% 3 . Of particular interest, our patient demonstrated not only subcutaneous and lymphatic regression, but also regression of lung involvement, which has been seen in only 10 cases in the literature [4][5][6][7][8][9][10][11][12] .…”

Section: Discussionmentioning

confidence: 78%

Spontaneous Regression of Metastatic Melanoma after Inoculation with Tetanus–Diphtheria–Pertussis Vaccine

Tran

Burt²,

Eapen

et al. 2013

Current Oncology

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After 3 months, a right inguinal lymph node dissection revealed involvement in 1 of 6 lymph nodes. Clinical examination and computed tomography imaging showed no evidence of distant metastasis. The patient was considered to have T2bN1aM0 stage iiib disease.One month later, the patient started a 4-week induction course of adjuvant high-dose interferon alfa at a daily dose of 36×10 6 U intravenously 5 days per week, followed by an 11-month course of 18×10 6 U interferon alfa 3 times weekly subcutaneously for maintenance. He tolerated this regimen well, with some symptoms of muscle pain, diarrhea, fever, and occasional headaches in addition to a slight elevation of liver enzymes.Eleven months into therapy, the patient developed multiple (approximately 15) in-transit metastases in the upper right thigh. These erythematous lesions ranged in size from 1 mm to 10 mm. Two other similar subcutaneous nodules were also seen on the upper lateral aspect of the right thigh (Figure 1). The patient underwent palliative radiotherapy of 40 Gy in 10 fractions to each nodule and 30 Gy in 10 fractions to the intervening skin, with good response. Followup imaging showed no other recurrence. The patient completed his 1-year course of interferon.Six months after the course of interferon, the patient developed a tender 5-mm nodule above the left nipple, a 5-mm axillary nodule, and a small nodule under the chin and on the central back. The chest lesion was excised and proved to be melanoma. A punch biopsy of the left axillary nodule revealed a malignant non-melanin tumour. Immunohistochemistry for melanoma was positive for S100, mart-1, and tyrosinase, and negative for HMB45, suggesting metastatic disease 1 . Immunohistochemistry of the primary lesion was not available. In addition, imaging showed new right-middle-lobe lung nodules measuring up to 3.5 mm in diameter, and an enlarged 15×13-mm right external iliac lymph node. Investigations were initiated for enrollment in a trial for what was now stage iv disease. ABSTRACTSpontaneous regression of metastatic melanoma is an exceedingly rare event, with only 76 well-documented cases in the literature since 1866. Here, we present the case of a patient who developed metastatic melanoma despite interferon therapy and who then achieved spontaneous regression shortly after a reaction to tetanus-diphtheria-pertussis vaccination. A common theme among these cases is the development of febrile illness before remission of the malignant disease. A brief overview of proposed mechanisms for these miraculous recoveries is presented, including a highlight on the potential role of the herv-k-mel viral marker, a nona-or decapeptide that appears in most melanomas, with homologies to peptides in pathogenic microorganisms.

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Section: Discussionmentioning

confidence: 78%

Spontaneous Regression of Metastatic Melanoma after Inoculation with Tetanus–Diphtheria–Pertussis Vaccine

Tran

Burt²,

Eapen

et al. 2013

Current Oncology

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“…This assumption has already been accepted in five cases. 5,6,18,25,27,29 It is also reasonable to assume that the metastases were in transit or were undetectable during the initial evaluation of the case. As the lymph node metastases and the pulmonary lesions regressed at 12 months after excision of the recurrent cutaneous melanoma and the parotid lymph node metastasis, it is possible that the favorable outcome might have resulted from stimulation of the immune mechanism by the surgery as has been suggested by R o h d e n b~r g .~~…”

Section: Case Reportmentioning

confidence: 99%

“…Bodurtha reviewed 29 cases in 1979. Regression of cutaneous or lymph node metastases 5 was more frequent than regression of visceral metastases 6 . The patient presented here had a lengito malignant melanoma of the face that metastasized to the regional lymph nodes and the lungs.…”

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confidence: 91%

Spontaneous Regression of Metastatic Malignant Melanoma

Mikhail¹,

Gorsulowsky²

1986

The Journal of Dermatologic Surgery and Oncology

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“…Hence, although it is accepted that prognosis of malignant melanoma is even worse in pregnancy than otherwise, termination of pregnancy does in no way improve the prognosis or lead to regression of malignant melanoma. Spontaneous regression of disseminated malignant melanoma after delivery has been recorded (E. P. Allen, 1955), but other instances of spontaneous regression without the added factor of pregnancy and in men are also reported (Sumner, 1953;Levison, 1955). Neither has treatment with androgens and oestrogens or the few trials of gonadectomy and adrenalectomy altered the course of established melanotic tumours.…”

Section: Hormonal Influencementioning

confidence: 99%

Malignant Melanoma

Cade¹

1957

BMJ

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Spontaneous Regression of a Malignant Melanoma

Cited by 22 publications

References 1 publication

Spontaneous Regression of Metastatic Melanoma after Inoculation with Tetanus–Diphtheria–Pertussis Vaccine

Spontaneous Regression of Metastatic Melanoma after Inoculation with Tetanus–Diphtheria–Pertussis Vaccine

Spontaneous Regression of Metastatic Malignant Melanoma

Malignant Melanoma

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