Journal
JOURNAL OF CUTANEOUS PATHOLOGY
Volume 48, Issue 11, Pages 1423-1426Publisher
WILEY
DOI: 10.1111/cup.14094
Keywords
melanoma; therapy; TVEC
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Talimogene laherparepvec (TVEC) is a genetically modified herpes simplex virus-1 used for the treatment of advanced melanoma. However, cutaneous reactions at the injection site may mimic recurrent melanoma. We reported a case of pseudolymphomatous reaction after TVEC therapy in a patient with metastatic melanoma.
Talimogene laherparepvec (TVEC) is a genetically modified herpes simplex virus-1 approved as an intralesional oncolytic immunotherapy for the treatment of advanced melanoma. Cutaneous reactions at the site of injection may mimic recurrent or progressive melanoma; histopathological findings have included chronic granulomatous dermatitis, neutrophilic dermatitis, lymphocytic dermatitis, and pigment incontinence. We report a 39-year-old male with metastatic stage IIIc melanoma treated with TVEC with clinical regression of melanoma lesions that later developed pink nodules at sites of prior injection. Histopathology demonstrated a nodular mononuclear infiltrate that stained strongly and diffusely with CD45 and CD20 with a surrounding rim of CD3-positive T-cells. Immunoglobulin gene rearrangement was negative for a clonal B-cell population. To our knowledge, this is the first report of a pseudolymphomatous reaction mimicking recurrent melanoma after TVEC therapy.
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