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

Daniel Ching, Elham Amini, Nathan Tobias Harvey, Benjamin Andrew Wood, Nima Mesbah Ardakani

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)399-404
Number of pages6
JournalPathology
Volume51
Issue number4
DOIs
Publication statusPublished - 1 Jun 2019

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Melanosis
Melanoma
Skin
Melanocytes
Skin Diseases
Epidermis
Physical Examination
Neoplasm Metastasis
Brain
Neoplasms

Cite this

Ching, Daniel ; Amini, Elham ; Harvey, Nathan Tobias ; Wood, Benjamin Andrew ; Mesbah Ardakani, Nima. / Cutaneous tumoural melanosis : a presentation of complete regression of cutaneous melanoma. In: Pathology. 2019 ; Vol. 51, No. 4. pp. 399-404.
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Cutaneous tumoural melanosis : a presentation of complete regression of cutaneous melanoma. / Ching, Daniel; Amini, Elham; Harvey, Nathan Tobias; Wood, Benjamin Andrew; Mesbah Ardakani, Nima.

In: Pathology, Vol. 51, No. 4, 01.06.2019, p. 399-404.

Research output: Contribution to journalArticle

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