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21 Once diagnosed, the next clinical challenge is to determine if the lesion represents a primary malignancy or represents a metastasis from a distant site

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While concerns persist regarding chronic inflammation from sustained proinflammatory cytokine expression (157), preclinical animal studies suggest that local adjuvant production is self-limiting, inducing effects in local draining lymph nodes and at the site of injection while being undetectable in circulation

* Results based on an in vitro study using human dermal fibroblasts