To the Editor.—
Dr. Gartmann would have us believe that a patient with metastatic melanoma could go on for four years after the removal of a single metastasis (without removal of the primary tumor) without signs or symptoms. On autopsy, no primary melanoma, or other primary malignant tumor, was found. It is true that much of the deeper (malignant) portion of the tumor in my initial case (Archives 110:599-601,1974) was surrounded by compact connective tissue. However, Dr. Gartmann failed to note an obvious transition zone between the area of benign nevus cells and the area of melanoma (Figure). When we first reported this case tenTop left, Transitional zone (M1 and M2) between lower part of dermal nevus (N) and area of maximum atypicality (hematoxylin-eosin, original magnification x 210). Top right, Lower part of dermal nevus (N in top left) shows typical type C nevus cells with small, regular
Okun MR. Malignant Melanomas-Reply to Dr. Gartmann. Arch Dermatol. 1975;111(10):1365–1366. doi:10.1001/archderm.1975.01630220129022
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