Mărgăritescu Irina, Chiriţă Aurel Doru, Vasilescu Florina
Laboratory of Anatomic Pathology, "Onco Team Diagnostic", Bucharest, Romania;
Rom J Morphol Embryol. 2014;55(2 Suppl):635-42.
Complete regression of primary cutaneous melanoma is a very rare phenomenon. Only 49 cases of well-documented completely regressed primary cutaneous melanoma have been reported to date. The clinical picture and histological findings may vary considerably. The presence of regional lymphadenopathy represents a necessary requisite for the diagnosis of completely regressed primary cutaneous melanoma. However, some cases lie outside these criteria and are difficult to diagnose and classify. Moreover, completely regressed melanoma is not specifically referred to in the current AJCC (American Joint Commission on Cancer) melanoma staging system. We report three cases of completely regressed primary cutaneous melanoma. One of the cases presented with unquestionable clinical and histopathological findings of completely regressed primary cutaneous melanoma, but without concomitant regional lymph node metastasis. As expected, this patient eventually developed nodal metastatic disease. An extraordinary case of a completely regressed melanoma that appeared in association with a congenital melanocytic nevus is also documented. This case revealed a unique type of regression that affected only the melanoma. The nevus was left undisturbed by the immunological response.
原发性皮肤黑色素瘤完全消退是一种非常罕见的现象。迄今为止，仅有49例记录充分的原发性皮肤黑色素瘤完全消退病例被报道。其临床表现和组织学发现可能有很大差异。区域淋巴结肿大的存在是诊断原发性皮肤黑色素瘤完全消退的必要条件。然而，有些病例不符合这些标准，难以诊断和分类。此外，当前美国癌症联合委员会（AJCC）黑色素瘤分期系统中并未特别提及完全消退的黑色素瘤。我们报告3例原发性皮肤黑色素瘤完全消退病例。其中1例具有原发性皮肤黑色素瘤完全消退的确切临床和组织病理学表现，但无区域淋巴结转移。不出所料，该患者最终发生了淋巴结转移疾病。本文还记录了1例与先天性黑素细胞痣相关的完全消退黑色素瘤的特殊病例。该病例显示出一种仅累及黑色素瘤的独特消退类型。免疫反应未对痣产生影响。
