Delayed Metastatic Polypoid Nodular Melanoma Diagnosis During COVID-19 Pandemic, Successful Treatment With Surgery and Nivolumab

Bradu, Stefan; Siegel, Daniel M.; Loyal, Jameson; Leaf, Andrea; Kurtti, Alana; Alapati, Usha; Jagdeo, Jared

doi:10.36849/jdd.6071

Cited by 2 publications

(3 citation statements)

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“…It is considered the most aggressive form of melanoma due to its high mitotic index and degree of cellular atypia. Its deep penetration level at the time of surgical excision causes the early invasion of the peripheral vasculature and lymphatics, leading to occult metastases and reserved prognosis [19,22,23].…”

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

Diagnostic and Therapeutic Particularities of Symptomatic Melanoma Brain Metastases from Case Report to Literature Review

Avino,

Ion,

Gheoca-Mutu

et al. 2024

Diagnostics

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The recent introduction of immunotherapy and targeted therapy has substantially enriched the therapeutic landscape of metastatic melanoma. However, cerebral metastases remain unrelenting entities with atypical metabolic and genetic profiles compared to extracranial metastases, requiring combined approaches with local ablative treatment to alleviate symptoms, prevent recurrence and restore patients’ biological and psychological resources for fighting malignancy. This paper aims to provide the latest scientific evidence about the rationale and timing of treatment, emphasizing the complementary roles of surgery, radiotherapy, and systemic therapy in eradicating brain metastases, with a special focus on the distinct response of intracranial and extracranial disease, which are regarded as separate molecular entities. To illustrate the complexity of designing individualized therapeutic schemes, we report a case of delayed BRAF-mutant diagnosis, an aggressive forearm melanoma, in a presumed psychiatric patient whose symptoms were caused by cerebral melanoma metastases. The decision to administer molecularly targeted therapy was dictated by the urgency of diminishing the tumor burden for symptom control, due to potentially life-threatening complications caused by the flourishing of extracranial disease in locations rarely reported in living patients, further proving the necessity of multidisciplinary management.

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Section: Discussion and Review Of The Literaturementioning

confidence: 99%

Diagnostic and Therapeutic Particularities of Symptomatic Melanoma Brain Metastases from Case Report to Literature Review

Avino,

Ion,

Gheoca-Mutu

et al. 2024

Diagnostics

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“…Nodular melanomas often fail to fulfill the diagnostic ABCDE (asymmetry, border, color, diameter, and evolving) rule for clinical recognition by being more symmetrical in early stages, having a smaller radial size, and presenting with only one color. Polypoid type, in terms of both gross anatomy and histology, reflects a tumor where more than half of the tumor exists largely above the skin surface [5].…”

Section: Discussionmentioning

confidence: 99%

“…Histologically, high levels of cellular and nuclear pleomorphism, cellular atypia, and a high mitotic index account for its poor prognosis. In addition, early metastases via vasculature and lymphatic invasion make polypoid malignant melanoma the deadliest of all melanomas [4,5]. Here, we report three cases of polypoid melanoma with divergent features that demonstrate its difficulty to diagnose clinically and the possible ways to avoid misdiagnosis.…”

Section: Introductionmentioning

confidence: 90%

A Case Presentation of Three Polypoid Melanomas With Divergent Features

Maury,

Jukic

2023

Cureus

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Polypoid melanoma, a subtype of nodular melanoma, is classified as the most aggressive and deadly form of cutaneous melanoma. Its rapid vertical growth phase and a wide array of divergent features make clinical diagnosis extremely difficult. This report includes three cases of polypoid melanoma that were all originally thought to be other benign lesions or non-melanoma cancer. These cases feature the variability of the clinical presentation of polypoid melanomas while emphasizing the importance of an annual skin examination, complete lesion biopsies, and working with experienced dermatopathologists for the correct diagnosis and prompt treatment of these cancers. By sharing these cases and general information on polypoid melanoma, we aim to spread awareness of this rarer subtype of melanoma and highlight the importance of having a broad differential list when presented with suspicious lesions.

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Delayed Metastatic Polypoid Nodular Melanoma Diagnosis During COVID-19 Pandemic, Successful Treatment With Surgery and Nivolumab

Cited by 2 publications

References 0 publications

Diagnostic and Therapeutic Particularities of Symptomatic Melanoma Brain Metastases from Case Report to Literature Review

Diagnostic and Therapeutic Particularities of Symptomatic Melanoma Brain Metastases from Case Report to Literature Review

A Case Presentation of Three Polypoid Melanomas With Divergent Features

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