Figure 4. Cutaneous tumor lysis syndrome following treatment with temsirolimus and bevacizumab.

 After the patient had progressed on chemoradiation, he was treated with temsirolimus (at a dose of 25 mg intravenously on days one, eight, and 15) and bevacizumab (at a dose of 15 mg/kg on day one) on 21 day therapy cycles. Distant (a) and closer (b) views show therapy-associated cutaneous tumor lysis syndrome presenting as several areas of full thickness ulcers (black arrows) on his chest that he experienced after his first cycle of treatment; the other areas of his chest and abdomen also demonstrated the dramatic resolution of his cutaneous metastases. The images have not previously been published; however, the details of the patient’s skin lesions and clinical course have previously been described [3-5].