Cutaneous tumoural melanosis: a presentation of complete regression of cutaneous melanoma.

Abstract:

:Partial regression is common in cutaneous melanoma; however, complete regression manifesting as tumoural melanosis is rare, conceptually challenging and under-reported. In this study we report on clinical, histological and molecular findings in four cases of completely regressed cutaneous melanoma with nodal or brain metastasis, followed by a comprehensive review of the literature. Our series included three women and one man with an average age of 60 years, and clinical presentation with hyper-pigmented cutaneous lesions. The main histological findings were expansile aggregates of melanophages with complete absence of malignant melanocytes on microscopic and immunohistochemical examination of the entire primary skin lesions, as well as substantial reduction in the number of junctional melanocytes in the overlying epidermis. NRAS mutant/BRAF wild type metastatic deposits were identified in three patients, with one patient having a BRAF V600E mutant metastatic tumour. Tumoural melanosis likely represents a partially effective immunological response to melanoma, with complete eradication of cutaneous disease and less effective systemic results. Patients with tumoural melanosis should be managed as potential completely regressed cutaneous melanoma, with comprehensive physical examination, imaging work up and close follow up.

journal_name

Pathology

journal_title

Pathology

authors

Ching D,Amini E,Harvey NT,Wood BA,Mesbah Ardakani N

doi

10.1016/j.pathol.2019.01.008

subject

Has Abstract

pub_date

2019-06-01 00:00:00

pages

399-404

issue

4

eissn

0031-3025

issn

1465-3931

pii

S0031-3025(18)30555-5

journal_volume

51

pub_type

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