A case report of a patient with inoperable primary diffuse leptomeningeal melanomatosis treated with whole-brain radiotherapy and pembrolizumab.
Medicine (Baltimore)
; 101(3): e28613, 2022 Jan 21.
Article
em En
| MEDLINE
| ID: mdl-35060532
ABSTRACT
RATIONALE Primary diffuse leptomeningeal melanomatosis (PDLM) is a rare disease that affects melanocytes in the leptomeninges. There is very limited data on the efficacy of immunotherapy in this setting. PATIENT CONCERNS A patient (23âyears old) was diagnosed with PDLM. Histologically, atypical melanocytic cells were also observed. DIAGNOSIS Immunohistochemistry showed positivity for S100 protein, NKiC3, and vimentin, and negativity for Melan-A and HMB-45, with a proliferation index of 30%. Extracranial disease was excluded using dermatological and other examinations, including positron emission tomography/computed tomography with 18F-fluorodeoxyglucose. INTERVENTIONS:
The patient was treated with whole-brain radiotherapy (10 fractions to a total dose of 30âGy) concomitantly with pembrolizumab and then continued with immunotherapy until disease progression with a maximum effect of partial remission on magnetic resonance imaging scans.OUTCOMES:
Progression-free survival was 6.0âmonths and overall survival 6.5âmonths. LESSONS This is one of the few case reports of an adult patient with this rare malignancy being treated with a programmed death-1 inhibitor with partial response. Immunotherapy in metastatic PDLM may be a reasonable therapeutic option.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Encéfalo
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Anticorpos Monoclonais Humanizados
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Imunoterapia
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Melanoma
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Neoplasias Meníngeas
Limite:
Adult
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Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article