Aparche Yang, MD; Marvin Klapman, MD; David S. Cassarino, MD, PhD
Dr. Yang is from the Department of Pathology, University of California, Los Angeles. Drs. Klapman and Cassarino are from the Southern California Permanente Medical Group, Los Angeles Medical Center. Dr. Klapman is from the Department of Dermatology and Dr. Cassarino is from the Department of Pathology.
The authors report no conflict of interest.
Correspondence: David S. Cassarino, MD, PhD, 4867 Sunset Blvd, 2nd Floor, Los Angeles, CA 90027 (david.s.cassarino@kp.org).
The prognostic significance of melanoma regression is controversial. Regression may be mediated by host immunity, apoptosis, and/or antiangiogenesis. The lymphocytic infiltrate in regressive melanomas consists of cytotoxic T cells with selective antitumor activity, which induces HLA class I–restricted melanoma lysis.8 Lymph node migration may result in T-lymphocyte priming and induction of antitumor immunity.9 Therefore, regression may indicate risk for sentinel LN metastasis.
It is possible that complete regression of melanoma does not truly exist, and late recurrence due to cancer dormancy is inevitable. Late recurrence is defined as first metastasis 10 years after complete removal of the PMM.10 Our patient has only been followed for 8 years, so this possibility cannot be entirely excluded.