Case report: Exceptional disease progression in a 70-year-old patient: generalized melanosis and melanuria in the course of metastatic melanoma - a case study
This case study documents an extraordinary disease progression in a 70-year-old patient diagnosed with metastatic melanoma. The patient’s condition advanced to an unusual manifestation characterized by generalized melanosis and melanuria, a rare and foreboding complication of metastatic melanoma. Th...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-01-01
|
| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2024.1332362/full |
| _version_ | 1797341241351864320 |
|---|---|
| author | Jacek Calik Jacek Calik Piotr Dzięgiel Piotr Dzięgiel Natalia Sauer Natalia Sauer |
| author_facet | Jacek Calik Jacek Calik Piotr Dzięgiel Piotr Dzięgiel Natalia Sauer Natalia Sauer |
| author_sort | Jacek Calik |
| collection | DOAJ |
| description | This case study documents an extraordinary disease progression in a 70-year-old patient diagnosed with metastatic melanoma. The patient’s condition advanced to an unusual manifestation characterized by generalized melanosis and melanuria, a rare and foreboding complication of metastatic melanoma. The clinical presentation involved rapid-onset skin darkening, primarily affecting the face and torso, along with darkened urine, marking the onset of melanuria. Despite extensive diagnostic evaluations, including abdominal ultrasound, neck ultrasound, thoracic CT scans, and endoscopic examinations, the exact metastatic sites remained elusive, demonstrating the diagnostic challenges associated with this condition. Laboratory tests revealed abnormal hematological and biochemical markers, along with elevated S100 protein levels, indicating disease progression. The patient underwent a surgical skin biopsy that confirmed the diagnosis of metastatic melanoma, leading to a multidisciplinary approach to treatment. Following this, the patient-initiated chemotherapy with dacarbazine (DTIC). Regrettably, this was necessitated by the absence of reimbursement for BRAF and MEK inhibitors as well as immunotherapy, and it subsequently led to rapid disease progression and a decline in the patient’s clinical condition. The patient’s condition further complicated with erysipelas and increased distress, ultimately leading to their unfortunate demise. This case highlights the aggressive nature of generalized melanosis, characterized by a rapid clinical course, substantial pigmentation, and limited response to conventional chemotherapy. Importantly, the patient had a BRAF mutation, emphasizing the urgency of exploring alternative treatment strategies. Patients with a BRAF mutation are excellent candidates for BRAF and MEK inhibitor treatment, potentially allowing them to extend their lifespan if this therapy were available. The challenges encountered in diagnosing, managing, and treating this aggressive form of metastatic melanoma underline the need for early detection, tailored therapeutic approaches, and ongoing research efforts to improve patient outcomes in such cases. |
| first_indexed | 2024-03-08T10:15:00Z |
| format | Article |
| id | doaj.art-cd36779f978d45b3baee06d04dad5e27 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-08T10:15:00Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-cd36779f978d45b3baee06d04dad5e272024-01-29T04:40:34ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-01-011410.3389/fonc.2024.13323621332362Case report: Exceptional disease progression in a 70-year-old patient: generalized melanosis and melanuria in the course of metastatic melanoma - a case studyJacek Calik0Jacek Calik1Piotr Dzięgiel2Piotr Dzięgiel3Natalia Sauer4Natalia Sauer5Department of Clinical Oncology, Wroclaw Medical University, Wrocław, PolandOld Town Clinic, Wroclaw, PolandDivision of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, Wrocław, PolandDepartment of Human Biology, Faculty of Physiotherapy, Wroclaw University of Health and Sport Sciences, Wrocław, PolandOld Town Clinic, Wroclaw, PolandFaculty of Pharmacy, Wroclaw Medical University, Wrocław, PolandThis case study documents an extraordinary disease progression in a 70-year-old patient diagnosed with metastatic melanoma. The patient’s condition advanced to an unusual manifestation characterized by generalized melanosis and melanuria, a rare and foreboding complication of metastatic melanoma. The clinical presentation involved rapid-onset skin darkening, primarily affecting the face and torso, along with darkened urine, marking the onset of melanuria. Despite extensive diagnostic evaluations, including abdominal ultrasound, neck ultrasound, thoracic CT scans, and endoscopic examinations, the exact metastatic sites remained elusive, demonstrating the diagnostic challenges associated with this condition. Laboratory tests revealed abnormal hematological and biochemical markers, along with elevated S100 protein levels, indicating disease progression. The patient underwent a surgical skin biopsy that confirmed the diagnosis of metastatic melanoma, leading to a multidisciplinary approach to treatment. Following this, the patient-initiated chemotherapy with dacarbazine (DTIC). Regrettably, this was necessitated by the absence of reimbursement for BRAF and MEK inhibitors as well as immunotherapy, and it subsequently led to rapid disease progression and a decline in the patient’s clinical condition. The patient’s condition further complicated with erysipelas and increased distress, ultimately leading to their unfortunate demise. This case highlights the aggressive nature of generalized melanosis, characterized by a rapid clinical course, substantial pigmentation, and limited response to conventional chemotherapy. Importantly, the patient had a BRAF mutation, emphasizing the urgency of exploring alternative treatment strategies. Patients with a BRAF mutation are excellent candidates for BRAF and MEK inhibitor treatment, potentially allowing them to extend their lifespan if this therapy were available. The challenges encountered in diagnosing, managing, and treating this aggressive form of metastatic melanoma underline the need for early detection, tailored therapeutic approaches, and ongoing research efforts to improve patient outcomes in such cases.https://www.frontiersin.org/articles/10.3389/fonc.2024.1332362/fullgeneralized melanosismetastatic melanomamelanuriaBRAF mutationmelanoma |
| spellingShingle | Jacek Calik Jacek Calik Piotr Dzięgiel Piotr Dzięgiel Natalia Sauer Natalia Sauer Case report: Exceptional disease progression in a 70-year-old patient: generalized melanosis and melanuria in the course of metastatic melanoma - a case study Frontiers in Oncology generalized melanosis metastatic melanoma melanuria BRAF mutation melanoma |
| title | Case report: Exceptional disease progression in a 70-year-old patient: generalized melanosis and melanuria in the course of metastatic melanoma - a case study |
| title_full | Case report: Exceptional disease progression in a 70-year-old patient: generalized melanosis and melanuria in the course of metastatic melanoma - a case study |
| title_fullStr | Case report: Exceptional disease progression in a 70-year-old patient: generalized melanosis and melanuria in the course of metastatic melanoma - a case study |
| title_full_unstemmed | Case report: Exceptional disease progression in a 70-year-old patient: generalized melanosis and melanuria in the course of metastatic melanoma - a case study |
| title_short | Case report: Exceptional disease progression in a 70-year-old patient: generalized melanosis and melanuria in the course of metastatic melanoma - a case study |
| title_sort | case report exceptional disease progression in a 70 year old patient generalized melanosis and melanuria in the course of metastatic melanoma a case study |
| topic | generalized melanosis metastatic melanoma melanuria BRAF mutation melanoma |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2024.1332362/full |
| work_keys_str_mv | AT jacekcalik casereportexceptionaldiseaseprogressionina70yearoldpatientgeneralizedmelanosisandmelanuriainthecourseofmetastaticmelanomaacasestudy AT jacekcalik casereportexceptionaldiseaseprogressionina70yearoldpatientgeneralizedmelanosisandmelanuriainthecourseofmetastaticmelanomaacasestudy AT piotrdziegiel casereportexceptionaldiseaseprogressionina70yearoldpatientgeneralizedmelanosisandmelanuriainthecourseofmetastaticmelanomaacasestudy AT piotrdziegiel casereportexceptionaldiseaseprogressionina70yearoldpatientgeneralizedmelanosisandmelanuriainthecourseofmetastaticmelanomaacasestudy AT nataliasauer casereportexceptionaldiseaseprogressionina70yearoldpatientgeneralizedmelanosisandmelanuriainthecourseofmetastaticmelanomaacasestudy AT nataliasauer casereportexceptionaldiseaseprogressionina70yearoldpatientgeneralizedmelanosisandmelanuriainthecourseofmetastaticmelanomaacasestudy |