| Autor: |
Jan Bronnert, Matthias Grade, Michael Respondek |
| Rok vydání: |
2020 |
| Předmět: |
|
| Zdroj: |
Surgical Case Reports. :1-2 |
| ISSN: |
2613-5965 |
| DOI: |
10.31487/j.scr.2020.06.23 |
| Popis: |
A 68-year-old man was admitted to our hospital with a dyspnea. On physical examination the patient was not distressed. Chest X-ray demonstrated an extensive left pleural effusion (A). Pleural aspiration showed an exsudate with elevated LDH of 464 U/L (0-100 U/l). The diagnostic thoracoscopy revealed disseminated black nodules on the visceral and parietal pleura (B) and a pleurodesis was performed after obtaining multiple biopsies. The melanoma cells showed a strong cytoplasmatic HMB-45 reaction (C). Immunohistochemical staining revealed a malignant melanoma with expression of PD-L1 in 3% of the tumor cells, the moleculargenetic examination proofed a BRAF V600 mutation. The patient was treated with the kinase inhibitor Trametinib and the tyrosinkinase inhibitor Tafiniar. He had initially a good response but died 10 months later after presenting to our clinic. 3 years prior the patient had a removal of a malign melanoma on the right upper thorax wall and the surgical exploration showed micrometastases in the sentinel lymphnode of the right axilla. (SSM Clark Level IV). At that time a immunotherapy with interferon alpha 2a was initiated. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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