Tumoral Melanosis: A Case Series of a Rare Clinical Entity

Abstract Tumoral melanosis (TM) is a rare entity thought to result from the complete regression of melanoma. Clinically, TM resembles malignant melanocytic lesions, presenting as hyperpigmented flat or papulonodular lesions. Histologically, TM lacks melanocytes, instead showing inflammation, fibrosi...

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Main Authors: Cesare Ariasi, Grazia Linda Artelli, Cristina Zane, Martina Perantoni, Simone Soglia, Giuseppe La Rosa, Vincenzo Maione, Marina Venturini, Claudia Zambelli, Gaetano Licata, Mariateresa Rossi, Mariachiara Arisi
Format: Article
Language:English
Published: Adis, Springer Healthcare 2025-02-01
Series:Dermatology and Therapy
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Online Access:https://doi.org/10.1007/s13555-025-01363-9
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author Cesare Ariasi
Grazia Linda Artelli
Cristina Zane
Martina Perantoni
Simone Soglia
Giuseppe La Rosa
Vincenzo Maione
Marina Venturini
Claudia Zambelli
Gaetano Licata
Mariateresa Rossi
Mariachiara Arisi
author_facet Cesare Ariasi
Grazia Linda Artelli
Cristina Zane
Martina Perantoni
Simone Soglia
Giuseppe La Rosa
Vincenzo Maione
Marina Venturini
Claudia Zambelli
Gaetano Licata
Mariateresa Rossi
Mariachiara Arisi
author_sort Cesare Ariasi
collection DOAJ
description Abstract Tumoral melanosis (TM) is a rare entity thought to result from the complete regression of melanoma. Clinically, TM resembles malignant melanocytic lesions, presenting as hyperpigmented flat or papulonodular lesions. Histologically, TM lacks melanocytes, instead showing inflammation, fibrosis, and melanophages. Diagnosing melanoma without melanocytes is challenging, and TM may also represent other regressed benign or malignant pigmented lesions. This study retrospectively analyzed 12 TM cases focusing on the clinical course, management, and potential for malignancy. Among the cases, 50% were associated with advanced or metastatic melanoma, supporting TM’s potential as a regressed melanoma. Conversely, in 50% of cases, TM occurred without primary or metastatic melanoma, suggesting possible regression of a benign or malignant epithelial lesion such as pigmented basal cell carcinoma (BCC) or seborrheic keratosis (SK) or confinement of melanoma by the immune system. Management included surgical excision and follow-up similar to that of melanoma. Sentinel lymph node biopsy (SLNB) was selectively performed based on clinical suspicion and multidisciplinary team discussions. In conclusion, TM should be considered potentially regressed melanoma, especially in patients with high disease burden, and the possibility of derivation from high-grade melanomas must always be considered. Given the inability to distinguish TM from completely regressed melanoma, clinicians must remain vigilant and suspect this origin during staging and follow-up. Comprehensive management and close monitoring are crucial to address TM’s clinical implications.
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spelling doaj-art-bd6a57660977485ebceacdb769d9e1462025-08-20T02:19:07ZengAdis, Springer HealthcareDermatology and Therapy2193-82102190-91722025-02-011551259127310.1007/s13555-025-01363-9Tumoral Melanosis: A Case Series of a Rare Clinical EntityCesare Ariasi0Grazia Linda Artelli1Cristina Zane2Martina Perantoni3Simone Soglia4Giuseppe La Rosa5Vincenzo Maione6Marina Venturini7Claudia Zambelli8Gaetano Licata9Mariateresa Rossi10Mariachiara Arisi11Department of Dermatology, University of BresciaDepartment of Dermatology, University of BresciaDepartment of Dermatology, University of BresciaDepartment of Dermatology, University of BresciaDepartment of Dermatology, University of BresciaDepartment of Dermatology, University of BresciaDepartment of Dermatology, University of BresciaDepartment of Dermatology, University of BresciaDepartment of Pathology, University of BresciaDepartment of Dermatology, Sant’Antonio Abate HospitalDepartment of Dermatology, University of BresciaDepartment of Dermatology, University of BresciaAbstract Tumoral melanosis (TM) is a rare entity thought to result from the complete regression of melanoma. Clinically, TM resembles malignant melanocytic lesions, presenting as hyperpigmented flat or papulonodular lesions. Histologically, TM lacks melanocytes, instead showing inflammation, fibrosis, and melanophages. Diagnosing melanoma without melanocytes is challenging, and TM may also represent other regressed benign or malignant pigmented lesions. This study retrospectively analyzed 12 TM cases focusing on the clinical course, management, and potential for malignancy. Among the cases, 50% were associated with advanced or metastatic melanoma, supporting TM’s potential as a regressed melanoma. Conversely, in 50% of cases, TM occurred without primary or metastatic melanoma, suggesting possible regression of a benign or malignant epithelial lesion such as pigmented basal cell carcinoma (BCC) or seborrheic keratosis (SK) or confinement of melanoma by the immune system. Management included surgical excision and follow-up similar to that of melanoma. Sentinel lymph node biopsy (SLNB) was selectively performed based on clinical suspicion and multidisciplinary team discussions. In conclusion, TM should be considered potentially regressed melanoma, especially in patients with high disease burden, and the possibility of derivation from high-grade melanomas must always be considered. Given the inability to distinguish TM from completely regressed melanoma, clinicians must remain vigilant and suspect this origin during staging and follow-up. Comprehensive management and close monitoring are crucial to address TM’s clinical implications.https://doi.org/10.1007/s13555-025-01363-9Tumoral melanosisCompleted regressed melanomaMelanomaRegression
spellingShingle Cesare Ariasi
Grazia Linda Artelli
Cristina Zane
Martina Perantoni
Simone Soglia
Giuseppe La Rosa
Vincenzo Maione
Marina Venturini
Claudia Zambelli
Gaetano Licata
Mariateresa Rossi
Mariachiara Arisi
Tumoral Melanosis: A Case Series of a Rare Clinical Entity
Dermatology and Therapy
Tumoral melanosis
Completed regressed melanoma
Melanoma
Regression
title Tumoral Melanosis: A Case Series of a Rare Clinical Entity
title_full Tumoral Melanosis: A Case Series of a Rare Clinical Entity
title_fullStr Tumoral Melanosis: A Case Series of a Rare Clinical Entity
title_full_unstemmed Tumoral Melanosis: A Case Series of a Rare Clinical Entity
title_short Tumoral Melanosis: A Case Series of a Rare Clinical Entity
title_sort tumoral melanosis a case series of a rare clinical entity
topic Tumoral melanosis
Completed regressed melanoma
Melanoma
Regression
url https://doi.org/10.1007/s13555-025-01363-9
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