Fatal disseminated bacillus Calmette-Guerin infection and arrested growth of cutaneous malignant melanoma following intralesional immunotherapy

Abstract

An 84-year-old man with aggressive cutaneous malignant melanoma, which failed to respond to systemic chemotherapy, was electively treated with intralesional bacillus Calmette-Guerin (BCG) immunotherapy. He died with widespread miliary granulomas, most likely representing disseminated BCG infection. However, at autopsy, the patient was found to have a minimal tumor burden and only a single focus of visceral metastatic malignant melanoma. In view of the clinically documented aggressive nature of this patient's disease, the arrested growth of his tumors is best attributed to the beneficial effect of BCG immunotherapy.