Treatment of recurrent mucosal melanoma of the oral cavity with topical imiquimod and pembrolizumab achieves complete histopathologic remission.
Treatment of recurrent mucosal melanoma of the oral cavity with topical imiquimod and pembrolizumab achieves complete histopathologic remission.
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DOI：
10.1136/jitc-2020-001219
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发表时间：
2021-10
影响因子：
10.9
通讯作者：
Yoon AJ
中科院分区：
文献类型：
--
作者：
Satish T;Khan S;Levin M;Carvajal R;Yoon AJ
粘膜黑色素瘤是黑色素瘤的一种亚型，治疗效果不如皮肤黑色素瘤。我们提出一个病例，口腔黏膜黑色素瘤复发，尽管多次切除和辅助替莫唑胺。局部咪喹莫特联合派姆单抗治疗获得缓解。一位56岁的女性在她的左前硬腭有一个色素团块。活检显示恶性黑色素瘤。由于边缘呈阳性，患者行切除并颈部清扫术，同时使用替莫唑胺辅助治疗3个月。累及硬腭的恶性黑色素瘤1年后复发，需要进一步切除。两年后，又发现两例色素病变；由于预期的发病率，进一步的切除被推迟。局部咪喹莫特治疗6周后，病变明显缩小。添加了辅助派姆单抗，6个月后观察到完全的组织病理学缓解。在诊断出新的原位黑色素瘤之前，患者病情持续缓解4年，需要额外5个月的咪喹莫特治疗。截至2021年4月，没有黑色素瘤的临床证据。局部咪喹莫特治疗口腔黑色素瘤的报道有限。在这里，咪喹莫特联合派姆单抗获得了完全的病理反应。
Mucosal melanomas constitute a subtype of melanoma with less effective treatments than cutaneous melanomas. We present a case of oral mucosal melanoma that recurred despite multiple resections and adjuvant temozolomide. Treatment with topical imiquimod combined with pembrolizumab achieved remission. A 56-year-old woman presented with a pigmented mass on her left anterior hard palate. Biopsy revealed malignant melanoma. The patient had resection with neck dissection with 3 months of adjuvant temozolomide due to positive margins. Malignant melanoma involving the hard palate recurred 1 year later requiring additional resection. Two years later, two additional pigmented lesions were found; further resections were deferred due to expected morbidity. Following 6 weeks of topical imiquimod treatment, the lesions shrunk significantly. Adjuvant pembrolizumab was added and complete histopathologic remission was observed in 6 months. The patient remained in remission for 4 years before new melanoma in situ was diagnosed, requiring five additional months of imiquimod. As of April 2021, there is no clinical evidence of melanoma. There are limited reports of oral melanoma treated with topical imiquimod. Here, imiquimod administered in combination with pembrolizumab achieved complete pathologic response.
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影响因子：
6.2
作者：
Shoushtari, Alexander N.;Munhoz, Rodrigo R.;Kuk, Deborah;Ott, Patrick A.;Johnson, Douglas B.;Tsai, Katy K.;Rapisuwon, Suthee;Eroglu, Zeynep;Sullivan, Ryan J.;Luke, Jason J.;Gangadhar, Tara C.;Salama, April K. S.;Clark, Varina;Burias, Clare;Puzanov, Igor;Atkins, Michael B.;Algazi, Alain P.;Ribas, Antoni;Wolchok, Jedd D.;Postow, Michael A.
通讯作者：
Postow, Michael A.
影响因子：
3.6
作者：
Tyrrell H;Payne M
通讯作者：
Payne M
影响因子：
13.8
作者：
Swetter, Susan M.;Chen, Frank W.;Egbert, Barbara M.
通讯作者：
Egbert, Barbara M.
影响因子：
6.2
作者：
Moreno, Mauricio A.;Roberts, Dianna B.;Hanna, Ehab Y.
通讯作者：
Hanna, Ehab Y.
影响因子：
3
作者：
WONG, JH;CAGLE, LA;MORTON, DL
通讯作者：
MORTON, DL