The Therapeutic Approach for Malignant Melanoma: Case 2

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The Therapeutic Approach for Malignant Melanoma

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
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John Mascarenhas, MD, an expert on myelofibrosis
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