[Regression in malignant melanoma. Definition, etiopathogenesis, morphology and differential diagnosis]

Pathologe. 2007 Nov;28(6):453-63. doi: 10.1007/s00292-007-0937-3.
[Article in German]

Abstract

Malignant melanoma is a neoplasm that more often tends to undergo regression. Clinically, variation in color is perhaps the most important hallmark of primary cutaneous melanoma. The change in color to white, off-white, blue-white and gray-white is a sign of (spontaneous) regression in malignant melanoma. Histopathologically the process starts with a dense lichenoid infiltrate of lymphocytes, and ends with fibrosis and/or melanosis within a thickened papillary dermis. The dense infiltrate of lymphocytes permeates the thin melanoma and destroys the atypical melanocytes in the epidermis and the papillary dermis. A key concern is how to define regression in a reproducible way. Using the following definition, a statistically significant risk of metastases can be demonstrated in thin melanomas (<1.0 mm) with extensive regression (>50%): "fibroplasia with an absence of epidermal and dermal involvement by melanoma cells, but allowing for (lentiginous) single-cell proliferation of atypical melanocytes along the dermo-epidermal junction".

Publication types

  • English Abstract

MeSH terms

  • Dermis / pathology
  • Diagnosis, Differential
  • Humans
  • Melanoma / diagnosis
  • Melanoma / immunology
  • Melanoma / pathology*
  • Neoplasm Regression, Spontaneous / immunology
  • Neoplasm Regression, Spontaneous / pathology*
  • Neoplasm Staging
  • Prognosis
  • Skin Neoplasms / diagnosis
  • Skin Neoplasms / immunology
  • Skin Neoplasms / pathology*