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ID 57737
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Matsuo, Toshihiko Okayama University Graduate School of Interdisciplinary Science and Engineeing in Health Systems ORCID Kakenhi
Tanaka, Takehiro Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Kakenhi
Yamasaki, Osamu Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Kakenhi
Abstract
Background. Primary malignant melanoma of the lacrimal sac is rare. A patient with lacrimal sac melanoma was presented, and 14 Japanese patients with lacrimal sac melanoma in the literature were reviewed. Case Presentation. A 78-year-old Japanese man was presented with painless swelling of the lacrimal sac on the left side. Dacryocystectomy revealed diffuse infiltration with large epithelioid cells, sometimes with pigments, which were positive for cocktail mix of antibodies to tyrosinase, melan A (MART-1), and HMB45, leading to pathological diagnosis of melanoma. One month later, positron emission tomography (PET) revealed 2 high-uptake sites (SUVmax = 10.29 and 15.38) at the levels of medial canthus and nasolacrimal duct, but no abnormal uptake in the other site of the body. The lesion had the BRAF V600E mutation. He began to take daily oral dabrafenib (BRAF inhibitor) and trametinib (MEK inhibitor), leading to no abnormal uptake on PET in half a year. He had stable disease in good physical status with small and weak uptake sites of lymph nodes on PET 1 year later. Results. In the review of 15 Japanese patients, including this patient, local recurrence was noted in 4 patients, regional lymph node metastasis only in 3, distant metastasis in 6, and no metastasis in 6. Five patients died within 2 years and the others were alive in short follow-up periods. Conclusions. Chemotherapy was the standard for local recurrence or metastasis. Emerging molecular target drugs, as shown in the present patient, would change the strategy for management of lacrimal sac melanoma.
Keywords
BRAF inhibitor
BRAF mutation
MEK inhibitor
PET/CT
dabrafenib
lacrimal sac
malignant melanoma
trametinib
Note
UNSP 2324709619888052
Published Date
2019-11-20
Publication Title
Journal of Investigative Medicine High Impact Case Reports
Volume
volume7
Publisher
Sage Publications
Start Page
1
End Page
6
ISSN
2324-7096
Content Type
Journal Article
language
英語
OAI-PMH Set
岡山大学
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DOI
Web of Science KeyUT
Related Url
isVersionOf https://doi.org/10.1177/2324709619888052
License
http://creativecommons.org/licenses/by/4.0/