Journal of Clinical & Experimental Dermatology Research
Open Access

A completely regressed melanoma firstly diagnosed by its abdominal wall metastasis: A case study

17^th European Dermatology Congress

March 01-03, 2018 | Paris, France

Koumoundourou Dimitra, Oikonomou Chrisa, Spiliopoulos Theofanis and Ravazoula Panagiota

General University Hospital of Patras, Greece

Posters & Accepted Abstracts: J Clin Exp Dermatol Res

Abstract :

Introduction & Aim: Complete regression of melanomas is a quite rare event and may be the explanation for metastatic tumors of indeterminate derivation. We describe a case of a metastatic nodule in the abdomen wall microscopically diagnosed as metastatic malignant melanoma. The primary site that was subsequently found was a totally regressed melanocytic lesion in the upper limb. Patient & Method: A 49-years old patient conferred to our hospital because of the presence of a mass of the abdominal wall measuring approximately 4 cm in greatest diameter. The mass was surgically treated and was sent at our pathology lab. On gross examination it was partially encapsulated, gray-colored and had a fleshy consistency. Results: Histologic examination revealed a malignant neoplasm comprising of nests of large epithelioid tumor cells with pleomorphic, hyperchromatic nuclei, presence of nucleoli and abundant eosinophilic cytoplasm. The cells strongly immunereacted with S-100, Melan-A, HMB-45 and MITF and were negative for epithelial markers. The diagnosis was compatible either with metastatic malignant melanoma or with a clear cell sarcoma. The patient was intimately searched for a melanoma primary and a low back skin lesion was also sent for pathologic evaluation, in which attenuated epidermis was seen in addition with many dermal melanophages, reactive vascular proliferation, a chronic inflammatory infiltrate and fibrosis. Conclusion & Discussion: By the histologic picture, compatible with complete regression of a primary cutaneous melanocytic lesion along with the absence of any other primary as well as the presence of a metastatic melanoma, the diagnosis of a completely regressed melanoma was made. Although partial regression can occur in 10-35% of melanomas, only 34 cases of totally regressed melanomas have been referred in the literature. The exact mechanism of regression remains to be elucidated however any patient with a metastatic melanoma needs a thorough cutaneous examination. dimikoum@yahoo.com J