Martín J M, Rubio M, Bella R, Jordá E, Monteagudo C
Servicio de Dermatología, Hospital Clínico Universitario, Valencia, Spain.
Actas Dermosifiliogr. 2012 Jun;103(5):401-10. doi: 10.1016/j.ad.2011.11.004. Epub 2012 Jan 28.
The complete regression of melanocytic tumors, confirmed by histology, has rarely been reported in the literature. It is very difficult to determine the malignant or benign nature of a regressed tumor, and on occasions, the only indication of malignancy is the subsequent development of metastasis.
We performed a descriptive study of melanocytic nevi that had undergone complete, histologically confirmed regression prior to excision in the dermatology department of our hospital over a period of 3 years. We included only lesions in which dermoscopy performed prior to regression showed features that suggested benignity. We assessed various clinical, dermoscopic, histologic, and immunohistochemical features.
The mean time to complete regression was 6.4 months. The main dermoscopic patterns observed were reticular and mixed reticular/globular. Unlike what is generally seen in melanomas, the main histologic finding was the presence of fine or lamellar fibrosis. In all cases, there was a predominance of CD8+ T cells.
The clinical, dermoscopic, and histologic features of the melanocytic nevi studied suggest the existence of a highly characteristic form of tumor regression characterized by very rapid regression and the involvement of a cytotoxic mechanism.
经组织学证实的黑素细胞肿瘤完全消退在文献中鲜有报道。很难确定消退肿瘤的恶性或良性性质，有时，恶性的唯一迹象是随后发生转移。
我们对我院皮肤科在3年期间切除前经组织学证实已完全消退的黑素细胞痣进行了描述性研究。我们仅纳入消退前进行的皮肤镜检查显示提示良性特征的病变。我们评估了各种临床、皮肤镜、组织学和免疫组化特征。
完全消退的平均时间为6.4个月。观察到的主要皮肤镜模式为网状和网状/球状混合。与黑色素瘤中通常所见不同，主要组织学发现是存在细纤维化或板层纤维化。在所有病例中，CD8 + T细胞占优势。
所研究的黑素细胞痣的临床、皮肤镜和组织学特征表明存在一种高度特征性的肿瘤消退形式，其特征为非常快速的消退和细胞毒性机制的参与。
