Survie prolongée et régression tumorale spontanée au cours d'un mélanome de stade IV : rôles possibles de la surrénalectomie et de la libération massive d'antigènes tumoraux

This rare case suggests the existence of specific factors resulting in tumour control. The favourable prognostic value of autoimmune signs has been discussed in stage III and IV melanoma. A number of studies have also suggested a link between prolonged survival and adrenalectomy for single and multiple adrenal metastases, with rare cases of complete regression of residual tumour following non-oncological surgery, as occurred in our patient. Other possible mechanisms include massive release of tumour antigens following metastatic rupture possibly resulting in massive stimulation of antitumour immune response, as suggested in certain animal models. Laboratory tests to validate these hypotheses have been indicated and could open up fresh therapeutic horizons.