Granulomatous skin reactions after tumor vaccine in two patients

Abstract

Two patients with HNPCC-syndrome (Hereditary Non-Polyposis Colorectal Cancer), an autosomal dominant genetic disorder in which patients are at higher risk of developing colorectal cancer, presented in our out-patient clinic with asymptomatic skin alterations at the injection sites of an experimental tumor-specific vaccine. The vaccine was given as part of a study in which colorectal carcinoma patients with lymph node and organ metastases and high microsatellite instability (MSI-H) received a vaccine containing fragments of specific tumor proteins. Both patients, a 60-year-old and 54-year-old male, had noted multiple slow-growing, firm, indolent erythematous to violaceous nodes of up to 4 cm in diameter on both upper arms at former injection sites approximately one year after receiving the tumor-specific vaccination (figure 1).

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