The Therapeutic Approach for Malignant Melanoma: Case 1
The Therapeutic Approach for Malignant Melanoma
June 2010
- A 73-year-old Caucasian male presented to his physician with a right pre-auricular pigmented lesion, 8 mm-diameter
- PMH: arterial hypertension, dyslipidemia, hyperuricemia and hypothyroidism, for which he has been medically treated
- He is a non-drinker and a former smoker
- In 2002, he had undergone a right nephrectomy for a spontaneous retroperitoneal hematoma. Consequently, he has chronic renal insufficiency
- Creatinine, 1.8 mg/dL
- GFR, 40 mL/min
- He otherwise maintains full autonomy in his daily activities and personal care
- He subsequently underwent surgical resection. Pathologic assessment revealed an ulcerated melanoma
- Breslow index 0.8 mm
- Clark level of III (pT1b, Stage IB)
- Since his surgery, he remains active and continues golfing 3 times per week
June 2016
- On routine follow-up, the patient presents with moderate asthenia that limited his daily activity, without other relevant clinical symptoms (ECOG PS 1)
- Physical examination did not detect any relevant findings
- Remarkable laboratory findings: Urea, 70 mg/dL; Creatinine 1.76 mg/dL; AST, 59 UI/L; ALT 52 UI/L; GGT 363 UI/L; Alk Phos, 204; LDH, 820 UI/L
- Full-body CT scan revealed the presence of pulmonary and hepatic nodules, no evidence of brain metastases
- He underwent core-needle biopsy of the largest hepatic lesion in segment IVb without any complications
- Pathology revealed metastatic melanoma
- Mutation testing:BRAF-negative
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