PMC10027906_01
Course of a subcutaneous melanoma metastasis under combination of MEK inhibitor and T-VEC in case 1. Ultrasound images from (A) April 2017, (B) April 2018 and (C) January 2019.
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T-VEC injections. The therapy was well tolerated and the metastases partly regressed ( Figure 3B ,  Supplementary Table 1 ).
PMC10027906_02
Course of cutaneous melanoma metastases in case 2. Clinical images from (A) November 2018, (B) January 2019, (C) March 2019 and (D) August 2019.
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Facing rapidly progressive cutaneous satellite metastases ( Figures 2A, B ), we initiated a local treatment with one T-VEC injection. In the middle of March 2019, after three injections of T-VEC and six weeks of trametinib, a regression of the cutaneous metastases was visible ( Figure 2C ). In August 2019, three symptomatic gluteal metastases were resected ( Figure 2D ) and the patient presented with an erysipelas of the gluteal region.
PMC10027906_03
Course of a subcutaneous melanoma metastasis under combination of MEK inhibitor and T-VEC in case 1. Ultrasound images from (A) April 2017, (B) April 2018 and (C) January 2019.
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T-VEC injections. The therapy was well tolerated and the metastases partly regressed ( Figure 3B ,  Supplementary Table 1 ).
Course of subcutaneous melanoma metastases under combination of MEK inhibitor and T-VEC in case 3. Ultrasound images from (A) August 2018, (B) February 2019 and (C) July 2019.
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In August 2018, the patient developed three subcutaneous in-transit metastases on the left lower limb again ( Figure 3A ). T-VEC injections. The therapy was well tolerated and the metastases partly regressed ( Figure 3B ,  Supplementary Table 1 ). One metastasis showed a fibrosed morphology in the ultrasound examinations ( Figure 3C ).