Introduction: Metastatic malignant cutaneous melanoma (MCM)—a highly immunogenic cancer—typically has a poor prognosis. Viscum album extracts (VAEs) have strong immune-stimulating, apoptogenic, and cytotoxic effects.

Case presentation: A 66-year-old MCM patient with newly diagnosed lymph node metastases opted for sole VAE treatment. VAEs were initially applied subcutaneously, and then later in exceptionally high, fever-inducing doses, both intravenously and intralesionally. The metastases shrunk over the following months, and after 2 years, all lesions had completely remitted (regional and hilar lymph nodes). The patient has been tumor free for 3.5 years at the time of publication (and for 5 years since initiation of intensified VAE treatment). Besides fever and flu-like symptoms, no side effects occurred.

Discussion: We presume that VAE triggered an increased release of tumor-associated antigens, enhanced immunologic recognition, and increased immune response against the tumor tissue and induced tumor remission.

Abbreviations: AJCC = American Joint Committee on Cancer, BRAF = rapidly growing fibrosarcoma type B gene, FDG = Fludeoxyglucose (18F), MCM = malignant cutaneous melanoma, ML = mistletoe lectin, PET-CT = positron emission tomography–computed tomography, UICC = Union internationale contre le cancer, VAE = Viscum album extracts, VT = viscotoxin.

Keywords: complete remission, fever, malignant cutaneous melanoma, Mistletoe, Viscum album extract

Citation: Werthmann, P. G., Hintze, A., & Kienle, G. S. (2017). Complete remission and long-term survival of a patient with melanoma metastases treated with high-dose fever-inducing Viscum album extract: A case report. Medicine, 96(46), e8731. https://doi.org/10.1097/MD.0000000000008731