Complete remission of cutaneous and subcutaneous melanoma metastases of the scalp with imiquimod therapy

Multiple cutaneous and subcutaneous melanoma metastases represent a therapeutic challenge. A 63-year-old man presented with multiple cutaneous and subcutaneous melanoma metastases on his right parieto-occipital region that appeared ten weeks after surgical excision of the primary tumor. Staging showed no further metastases. Because of the large area of cutaneous metastatic spread, the location and the limited possibility of a complete excision, we decided to begin immunomodulatory therapy with imiquimod applied for eight hours daily five days a week. After six weeks of imiquimod monotherapy, a partial remission of the cutaneous metastases had occurred. After 17 months, the remission of these metastases was complete. Four months later the patient is still free of cutaneous, visceral, cerebral and lymph node metastases.