April 2017

• A 52-year-old female presented to her dermatologist with a pigmented lesion which had recently become darker; she had it removed for cosmetic reasons
  • Pathology revealed a melanoma with a depth of 2.3 mm
  • Genetic testing;BRAF V600mutation-positive
• LDH, WNL (174 UI/L)
• She underwent wide local excision and sentinel node mapping; staining is positive for melanoma in the right axillary node
• Complete dissection of the right axilla reveals no additional involved nodes
• CT of the chest, abdomen, and pelvis showed multiple masses in both lungs, the largest being 5 mm
• She underwent core-needle biopsy of the largest lung lesion
  • Pathology revealed metastatic melanoma
  • Mutation testing:BRAF-positive
• The patient is started on dabrafenib 150 mg bid and trametinib 2 mg qd