This report describes the case of a 71-year-old woman with nodular melanoma who experienced rapid clinical deterioration 3 weeks after receiving immunotherapy treatment. Given this presentation, there was high suspicion for tumor hyperprogression, which has been observed as a paradoxical response to the use of immunotherapy in the treatment of melanoma. Histopathologic and genomic changes of primary tumor are documented at several different timepoints relative to immunotherapy treatment that may depict important alterations associated with hyperprogressive disease. To our knowledge, this case is the first to document the evolution of histopathologic features of melanoma associated with hyperprogressive disease.
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