Abstract
Spontaneous regression of metastatic melanoma is an exceedingly rare event, with only 76 well-documented cases in the literature since 1866. Here, we present the case of a patient who developed metastatic melanoma despite interferon therapy and who then achieved spontaneous regression shortly after a reaction to tetanus-diphtheria-pertussis vaccination. A common theme among these cases is the development of febrile illness before remission of the malignant disease. A brief overview of proposed mechanisms for these miraculous recoveries is presented, including a highlight on the potential role of the herv-k-mel viral marker, a nona- or decapeptide that appears in most melanomas, with homologies to peptides in pathogenic microorganisms.
Highlights
CASE DESCRIPTIONA 44-year-old white man with no past medical history developed local irritation of a longstanding nevus on the right anterior tibial area, which progressed to ulceration and bleeding over several months
Spontaneous regression of metastatic melanoma is an exceedingly rare event, with only 76 well-documented cases in the literature since 1866
We present the case of a patient who developed metastatic melanoma despite interferon therapy and who achieved spontaneous regression shortly after a reaction to tetanus–diphtheria–pertussis vaccination
Summary
A 44-year-old white man with no past medical history developed local irritation of a longstanding nevus on the right anterior tibial area, which progressed to ulceration and bleeding over several months. The patient developed multiple (approximately 15) in-transit metastases in the upper right thigh. These erythematous lesions ranged in size from 1 mm to 10 mm. A second primary tumor cannot be ruled out, it is highly unlikely This patient has since been regularly followed with clinic visits and imaging that continues to demonstrate a disease-free state. The patient had received 1 year’s worth of adjuvant interferon therapy 9 months after initial presentation (which failed) and superficial local disease control with excision and radiotherapy 20 months after his first biopsy
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