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Spontaneous regression of metastatic melanoma is an exceedingly rare event, with only 76 well-documented cases in the literature since 1866. Here, we present the case of a patient who developed metastatic melanoma despite interferon therapy and who then achieved spontaneous regression shortly after a reaction to tetanus-diphtheria-pertussis vaccination. A common theme among these cases is the development of febrile illness before remission of the malignant disease. A brief overview of proposed mechanisms for these miraculous recoveries is presented, including a highlight on the potential role of the HERV-K-MEL viral marker, a nona- or decapeptide that appears in most melanomas, with homologies to peptides in pathogenic microorganisms. [ABSTRACT FROM AUTHOR]

Therapeutic irradiation of fields containing cardiac pacemakers presents a unique problem to pacemaker physicians and radiation oncologists alike. The present case involved a proposed radiation field containing both subclavian pockets. As an alternative solution, the Cordis model 334A implantable pulse generator was irradiated using a backup temporary pacemaker that was kept outside of any significant radiation exposure. A total of 60 Gy was delivered in 30 fractions, with backup temporary pacing and continuous ECG monitoring used for the first 5 fractions. Frequent re-evaluation of pacing and sensing function revealed no changes as a result of irradiation; following radiotherapy, transtelephonic monitoring showed normal pacemaker function for a 4 month follow-up. This represents a useful alternative, particularly for nonmultiprogrammable pacemakers that are made of more radiation-resistant technology. [ABSTRACT FROM AUTHOR]