Spontaneous regression of multiple bone metastases in malignant melanoma

Everson and Cole (1966) in their classic monograph defined spontaneous regression of malignant disease as “the partial or complete disappearance of a malignant tumour in the absence of all treatment or in the presence of therapy which is considered inadequate to exert a significant influence on neoplastic disease”. It is generally agreed (Fauvet et af, I960, 1964; Cappefaere et al, 1973) that regression of malignant melanoma must fulfil at least the following criteria: 1. clinical and histological diagnosis of melanoma; 2. no therapeutic manipulation that could account for the regression; 3. clinical observation of regression of existing lesions including radiographs, photographs, etc; 4. if possible, histopathological studies of tissue sites where regression has presumably occurred. We describe a case of spontaneous regression of multiple bone metastases following palliative radiotherapy in a patient with malignant melanoma and discuss the possible mechanisms. In September 1985, a 40-year-old Scotsman was referred to the Roual Marsden Hospital following local excision of a pigmented lesion on the dorsal surface of the distal part of the left forearm. The lesion had been present for 5 years and for the previous 6 months had increased in size and depth of colour and bled on trauma. The only other medical history of note was vagotomy for duodenal ulceration 20 years previously.