Metastatic oral melanoma: radiotherapy and nivolumab treatment
DOI:
https://doi.org/10.11606/issn.1679-9836.v99i6p619-625Keywords:
Melanoma, Immunotherapy, Nivolumabe, RadiotherapyAbstract
INTRODUCTION: Oral Mucosa Melanoma (MMO) is a rare malignant neoplasm that accounts for about 0.5% of all oral tumors. This melanoma is associated with atypical proliferation of melanocytes present in the mucosal epithelium. The treatment can be performed by surgical resection, with chemotherapy and radiotherapy as adjunct treatment. In cases with metastatic lymph nodes, adjuvant treatment with immunotherapy may be used. CASE REPORT: An 83-year-old male patient had as main complaint a dark tumor in the gingiva, hard palate and right maxillary sinus, with cervical and mediastinal lymph nodes and pulmonary metastases. In 2015, he started treatment with DTIC and obtained partial response. After one year, he started treatment with Imatinib, obtained partial response and then disease progression. In 2016, he started treatment with Nivolumab and local radiotherapy with IMRT. He had complete local remission and partial systemic remission. Moreover, the treatment had as immune-mediated side effects adrenal insufficiency, hypothyroidism, diabetes mellitus and vitiligo on face and left flank. Our report aims to present a case of oral mucosal melanoma in the gingiva, palate and maxillary sinus with systemic metastases, treated with Nivolumab and radiotherapy, compare it with other reports in the literature and highlight the complications of immunotherapy.
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Copyright (c) 2020 João Carlos Simões, Mateus Rocco, Beatriz Sayuri Nakamura
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