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1/42. A natural cytotoxic T cell response in a spontaneously regressing human melanoma targets a neoantigen resulting from a somatic point mutation.

    We have studied a case of human primary melanoma displaying the classical signs of a spontaneous regression in order to characterize potentially efficient anti-tumor T cell responses. In a previous series of experiments a unique TCR Vbeta16 T cell was shown to be highly expanded at the tumor site. The corresponding clone was isolated in vitro and found to be a CD8 cytotoxic T lymphocyte with a strong and selective cytolytic activity against the autologous tumor cell line. Here, we demonstrate that this predominant Vbeta16 tumor-infiltrating lymphocyte recognizes a peptide encoded by a novel unconventional myosin class I gene. This peptide includes a mutation due to a single nucleotide substitution. The resulting Glu-->Lys replacement at position 911 of the coding sequence is critical to generate the recognized T cell epitope. These experiments demonstrate the existence of a natural tumor-specific cytolytic T cell response in a primary regressing human melanoma lesion.
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ranking = 1
keywords = melanoma
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2/42. A MAGE-6-encoded peptide is recognized by expanded lymphocytes infiltrating a spontaneously regressing human primary melanoma lesion.

    In recent years, experiments based on the in vitro stimulation of either autologous peripheral blood lymphocytes or tumor-infiltrating lymphocytes with melanoma cells have shown that distinct members of the large MAGE gene family encode tumor-associated antigenic peptides. However, little is still known about natural anti-MAGE responses in vivo. We have studied a case of spontaneously regressing human melanoma, hypothesizing that in this unique situation, the host immune system had developed an efficient cytotoxic T lymphocyte (CTL) response against the cancer cells. Amongst the dense tumor infiltrate, certain clonal populations of T cells were shown to be amplified, thereby suggesting that an antigen-driven selection had occurred at the tumor site. One of the expanded tumor-infiltrating lymphocytes was shown to be a Vbeta13 CD8 CTL displaying a strong and selective cytotoxic activity against the autologous melanoma cells. Here we show that this cytotoxic T cell clone recognizes a MAGE-6-encoded peptide. MAGE-6 is therefore the fourth gene of the MAGE family shown to encode antigenic peptide recognized by T cells. Together, these data provide further evidence that T cell responses against MAGE antigens may naturally develop in vivo.
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ranking = 1.1666666666667
keywords = melanoma
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3/42. Spontaneous partial regression of malignant melanoma and its first metastasis. Case report.

    A case of malignant melanoma with partial regression of the original lesion and its first metastasis is reported. At the time of almost complete disappearance of the primary lesion a lymph node metastasis was removed and it consisted of necrotic tissue containing masses of melanin pigment. There then was a rather rapid progress of the original lesion and of other metastases and the patient died of disseminated metastases of malignant melanoma three years after the operation.
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ranking = 2.0156939226135
keywords = malignant melanoma, melanoma
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4/42. Complete spontaneous regression of Merkel cell carcinoma: a review of the 10 reported cases.

    BACKGROUND: Merkel cell (neuroendocrine) carcinoma (MCC) is a very aggressive primary cutaneous neoplasm occurring most often on the head and neck of the elderly. Complete spontaneous regression (CSR) of MCC was first described in 1986. Since then other cases have been reported bringing the total to 10. OBJECTIVE: To review these 10 cases and obtain long-term follow-up data, to compare them for similarities and differences. METHOD: Each original case report was extensively reviewed and authors contacted in most cases for confirmation and updated information. RESULTS: In no case did MCC recur after CSR was noted, although follow-up information in some cases was short. When CSR occurred, it was swift and dramatic with complete regression of skin and lymph node metastasis in 1-3 months. CONCLUSION: While only 10 cases of CSR is a small number, MCC is itself a rare malignancy with just over 600 reported cases. Today most cases of MCC receive aggressive combined therapy effectively precluding diagnosis of CSR. The nature of regression in these 10 cases may point toward future immunologic therapy just as similar cases of CRS in patients with melanoma have led to advances in the immunologic treatment for that malignancy.
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ranking = 0.16666666666667
keywords = melanoma
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5/42. Long-term spontaneous regression of malignant melanoma with visceral metastases. Report of a case with immunologic profile.

    A case of a 58-year-old woman with viscerally metastatic malignant melanoma is presented 12 years after spontaneous and complete regression of disease. diagnosis of primary and metastatic lesions was confirmed by review of tissue sections. The presence and subsequent absence of visceral metastases were documented by open liver biopsies. Sections of metastatic lesions revealed extensive necrosis of tumor and infiltration of lymphocytes and plasma cells. skin testing showed a strongly positive delayed hypersensitivity response to dinitrochlorobenzene (DNCB), to a standard battery of bacterial and fungal antigens, and to two of four preparations of allogeneic melanoma antigens. Values for cell- and serum-mediated cytotoxicity against melanoma cells and the response of the patient's lymphocytes to phytohemagglutinin were slightly above the normal range. A review of the literature reveals 13 other cases of long-term spontaneous regression of melanoma. None of these, however, had biopsy evidence of visceral disease. In each of the 13 cases, regression was associated with an event that might be inferred to have altered the patient's hormonal or immune status. This patient also provides evidence of a complete, spontaneous, and long-term remission of metastatic disease associated with the spontaneous development of host immunity.
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ranking = 2.1797449355113
keywords = malignant melanoma, melanoma
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6/42. Spontaneous regression of metastatic malignant melanoma of the parotid gland and neck lymph nodes: a case report and a review of the literature.

    We report the case history of a patient with complete spontaneous regression of metastatic cutaneous melanoma with parotid and neck lymph node metastases. Complete spontaneous regression of metastatic melanoma is very rare, with an estimated incidence of 0.22%-0.27%. We review the literature on this subject. Elucidation of the process of spontaneous regression may offer the possibility of improved methods of treating and preventing cancer.
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ranking = 1.6771292817423
keywords = malignant melanoma, melanoma
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7/42. Spontaneous regression of the primary lesion of a metastatic maligvant melanoma.

    An atypical elderly patient with spontaneous regression of a primary lesion of malignant melanoma is presented. The 12 previously reported cases are also reviewed. The histological diagnosis of spontaneous regression of a melanoma can still be made after the regression appears to be grossly complete. All localized areas of depigmentation, or of scarring, should be biopsied when searching for an "occult" primary.
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ranking = 1.1692823204356
keywords = malignant melanoma, melanoma
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8/42. Spontaneous regression of subcutaneous metastasis of cutaneous melanoma.

    A case is presented of a 44-year-old Caucasian man who was operated on in October of 1988 for a cutaneous melanoma in his trunk and who in the space of 1 year manifested a single subcutaneous nodule compatible with a metastasis of melanoma by fine-needle aspiration biopsy. No other abnormal findings were revealed by physical and instrumental examinations. During the subsequent hospitalization, we witnessed (in conjunction with the occurrence of painful symptoms in the hands of an inflammatory nature) the total, progressive, spontaneous regression of the metastasis, which was confirmed by the clinic and the tests. After 15 months of follow-up, the patient has not shown any further signs of illness.
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ranking = 1
keywords = melanoma
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9/42. Utility of the wood's light: five cases from a pigmented lesion clinic.

    We demonstrate the utility of the wood's light in a practice that specializes in the evaluation of pigmented lesions. The wood's light assisted the physician in locating the site of a completely regressed primary cutaneous melanoma, determining the clinical borders of a lentigo maligna melanoma, differentiating between agminated naevi and a naevus spilus and detecting the recurrence of pigmentation after the excision of a dysplastic naevus, and also proved useful in monitoring a large segmental speckled atypical lentiginous naevus for change. Despite the availability of many 'high-tech' imaging and diagnostic devices designed to evaluate skin lesions, the relatively simple wood's lamp continues to be of great value. We encourage physicians not to abandon the use of the wood's light in their clinical practice.
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ranking = 0.33333333333333
keywords = melanoma
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10/42. Completely regressed primary cutaneous malignant melanoma with nodal and/or visceral metastases: a report of 5 cases and assessment of the literature and diagnostic criteria.

    BACKGROUND: Partial regression of primary cutaneous malignant melanoma is not uncommon and may predict a higher likelihood of metastasis and decreased survival. Complete histologic regression of a primary cutaneous melanoma is a rarer occurrence, with only 34 cases reported in the English-language or English language-summarized literature. observation: We detail 4 cases of complete histologic regression of primary cutaneous melanoma, discovered at presentation with metastatic disease. A pigmented lesion or its remnant, coupled with historical information, was strongly suggestive of cutaneous melanoma. Histologic examination of the lesions, using multiple levels and immunohistochemical stains, failed to reveal residual melanoma. Our cases are typified by the presence of metastasis of melanoma to regional lymph nodes, with the absence of other suspect skin lesions or malignancies. In addition, we present a fifth case involving a completely regressed lesion on the scalp in a patient with cerebral melanoma metastasis and comment on the implications of this case to accepted diagnostic criteria, proposing that consideration of modification to the criteria be entertained. CONCLUSION: The concept of completely regressed primary cutaneous melanoma is reviewed and the literature critically appraised. When one considers a diagnosis of completely regressed primary cutaneous melanoma, cases must be well documented and biopsy proven. patients with metastatic melanoma and an occult primary lesion require a thorough skin examination, with serious consideration given to the possibility of completely regressed cutaneous melanoma.
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ranking = 3.3464116021779
keywords = malignant melanoma, melanoma
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