Inflammatory melanoma in transit metastases with complete response to talimogene laherparepvec

TVEC: Talimogene laherparepvec INTRODUCTION Inflammatory melanoma was first described in 1984 in 2 patients presenting with nodular cutaneous melanomas resected from the back followed 4 to 12 months later by recurrence in the form of diffuse, indurated, erythematous skin 20-25 cm in diameter with scattered nodularity. Microscopic examination found melanoma cells in the dermis and dermal lymphatics. Both patients died of hematogenous metastases within 6 months of their inflammatory melanoma recurrences. Although histopathologic examination of melanoma frequently finds an associated inflammatory cell infiltrate, gross clinical inflammation is extremely rare. A search of PubMed and Google Scholar performed on August 5, 2016 found 3 additional case reports of inflammatory melanoma, 2 of which involved direct dermal lymphatic extension from grossly involved lymph nodes. Here we report the first, to our knowledge, successfully treated case of surgically incurable inflammatory melanoma with emphasis on molecular and immunophenotypic characterization.