PMC9731864_01
Clinical mapping and radiation dose distribution. A, Clinical target area outlined with copper wire. B, The yellow isodose line represents a highly conformal 100% of the dose (6 Gray x5).
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Given the presence of multiple lesions, he received high-dose rate brachytherapy (5 fractions of 6 Gray over 3 weeks) with moderate improvement (Fig 1).
Metastatic melanoma regression after brachytherapy and imiquimod. A, Case 1: Scalp lesions at end of imiquimod with increased erythema. B, Case 1: Scalp lesions 2 months postimiquimod. C, Case 2: Scalp lesions 1 month postimiquimod. D, Case 2: Scalp lesions 4 months postimiquimod. E, Case 3: Multiple nodules surrounding excision. F, Case 3: Crusting nodules postbrachytherapy and preimiquimod.
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Two months later, he developed scalp lesions which were biopsied and demonstrated metastatic melanoma (Fig 2, E). Given the presence of numerous ITMs on a reconstructed area, he underwent high-dose rate brachytherapy (5 fractions of 6 Gray over 2 weeks) (Fig 2, F), followed by 3 months of daily imiquimod application with excellent response.
PMC9731864_02
Metastatic melanoma regression after brachytherapy and imiquimod. A, Case 1: Scalp lesions at end of imiquimod with increased erythema. B, Case 1: Scalp lesions 2 months postimiquimod. C, Case 2: Scalp lesions 1 month postimiquimod. D, Case 2: Scalp lesions 4 months postimiquimod. E, Case 3: Multiple nodules surrounding excision. F, Case 3: Crusting nodules postbrachytherapy and preimiquimod.
gr2.jpg
PMC9731864_03_gr2.jpg
fig2
Two months later, he developed scalp lesions which were biopsied and demonstrated metastatic melanoma (Fig 2, E). Given the presence of numerous ITMs on a reconstructed area, he underwent high-dose rate brachytherapy (5 fractions of 6 Gray over 2 weeks) (Fig 2, F), followed by 3 months of daily imiquimod application with excellent response.
PMC9731864_03
Metastatic melanoma regression after brachytherapy and imiquimod. A, Case 1: Scalp lesions at end of imiquimod with increased erythema. B, Case 1: Scalp lesions 2 months postimiquimod. C, Case 2: Scalp lesions 1 month postimiquimod. D, Case 2: Scalp lesions 4 months postimiquimod. E, Case 3: Multiple nodules surrounding excision. F, Case 3: Crusting nodules postbrachytherapy and preimiquimod.
gr2.jpg
PMC9731864_03_gr2.jpg
fig2
Two months later, he developed scalp lesions which were biopsied and demonstrated metastatic melanoma (Fig 2, E). Given the presence of numerous ITMs on a reconstructed area, he underwent high-dose rate brachytherapy (5 fractions of 6 Gray over 2 weeks) (Fig 2, F), followed by 3 months of daily imiquimod application with excellent response.