Patient Case: A 62-Year-Old Female with Stage IV BRAF-Mutated Melanoma
Michael B. Atkins, MD, reviews a case involving a female patient who was diagnosed with stage IV BRAF-mutated melanoma, and shares insights on the patient’s prognosis and his approach to diagnosis.
Case: A 62-Year-Old Female with Stage IV Melanoma
- A 62-year-old female consulted with her dermatologist for removal of a pigmented lesion that had recently become darker.
- She noted that she had been experiencing persistent fatigue, shortness of breath, and a dry cough that she attributed to a prior COVID-19 infection.
- LDH: 174 UI/L
- Excisional biopsy reveals melanoma with a Breslow depth of 1.2 mm, ulcerated, mitotic rate 4/mm2
- The patient underwent wide local excision and sentinel node mapping
- Staining was positive for melanoma in the right axillary node
- CT of the chest, abdomen, and pelvis indicated multiple lesions in both lungs
- The patient underwent core-needle biopsy of the largest lung lesion, measuring 1 cm
- Pathology revealed metastatic melanoma, cutaneous nonacral with a positive BRAF V600E mutation
- ECOG PS 1
- Diagnosis: Stage IV Melanoma, T2b N1a M1b
This is a video synopsis/summary of a Case-Based Peer Perspectives episodefeaturing Michael B. Atkins, MD.
A 62-year-old woman presented to her dermatologist for removal of a pigmented lesion on her shoulder that had recently become darker. She reported experiencing persistent fatigue, shortness of breath, and a dry cough that she attributed to prior COVID-19 infection. Her lactate dehydrogenase level was 174 U/L, which is within normal range. An excisional biopsy of the shoulder lesion revealed a melanoma with a Breslow thickness of 1.2 mm; it was ulcerated and had a high mitotic rate. She underwent wide local excision and sentinel lymph node mapping, which showed melanoma metastasis in a right axillary sentinel lymph node. A CT of the chest, abdomen, and pelvis showed multiple lung lesions. A core needle biopsy of the largest lung lesion revealed melanoma with a positive BRAF V600E mutation. A brain MRI showed no metastases. Her ECOG performance status was 1 due to fatigue and cough. She received a diagnosis of stage IV melanoma, T2b, N1a, M1b.
Video synopsis is AI-generated and reviewed by Targeted Oncology® editorial staff.
