The fund of knowledge regarding the versatility of presentation of MM metastases is still quite incomplete. The recent literature\r\npertaining to the current understanding of the mechanisms underlying two special features of MM metastasis is reviewed. On\r\nthe one hand, a long disease-free interval (MM dormancy) may occur before the surge of overt metastases. On the other hand,\r\nthe so-called MM smouldering phenomenon refers to the condition where regional metastases wax and wane for long periods\r\nof time on restricted skin regions. It is important to emphasize that local micrometastases often predict sentinel lymph node\r\ninvolvement but may not reflect progression of the primary MM to full-blown visceral metastatic competence. It is likely that\r\na combination of factors impacts the versatile MM metastasic progression. Among the main factors, one has to mention the\r\nphenotypic heterogeneity and variability in the phenotype ofMMcells, the presence ofMMstemcells andMMcells engaged in an\r\namplification proliferation pool, as well as the host immune response, and possibly the induction of a particular stromal structure\r\nand vascularity.
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