Effective Immunotherapy in Bone Marrow Metastatic Melanoma Presenting with Disseminated Intravascular Coagulopathy
Malignant melanoma is responsible for the majority of skin cancer deaths and is increasing in prevalence. Bone marrow (BM) involvement by melanoma is rare in the absence of widespread visceral disease. Here, we report the case of a 30-year-old female who presented to the hospital with back pain, low...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Immunology |
| Online Access: | http://dx.doi.org/10.1155/2018/4520294 |
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| author | Bolanle Gbadamosi Daniel Ezekwudo Bhadresh Nayak Zhou Yu Sandra Gjorgova-Gjeorgjievski Ming Xie Colvin Robert Ishmael Jaiyesimi Marianne Huben |
| author_facet | Bolanle Gbadamosi Daniel Ezekwudo Bhadresh Nayak Zhou Yu Sandra Gjorgova-Gjeorgjievski Ming Xie Colvin Robert Ishmael Jaiyesimi Marianne Huben |
| author_sort | Bolanle Gbadamosi |
| collection | DOAJ |
| description | Malignant melanoma is responsible for the majority of skin cancer deaths and is increasing in prevalence. Bone marrow (BM) involvement by melanoma is rare in the absence of widespread visceral disease. Here, we report the case of a 30-year-old female who presented to the hospital with back pain, low-grade fever, and easy bruising. She was found to be bicytopenic and in disseminated intravascular coagulopathy (DIC). Surprisingly, BM biopsy showed extensive involvement by metastatic malignant melanoma in the absence of visceral or brain metastasis. The unique presentation of this case and the challenge of management of a potentially treatable cancer in a critically ill patient are discussed, alongside a review of published cases of metastatic melanoma in the BM and an exploration of currently available treatment options. The excellent response of our patient to combined immune checkpoint inhibitors has yet to be paralleled in the available literature. |
| format | Article |
| id | doaj-art-8ea9eda6b69e45d2a167a96173121b40 |
| institution | OA Journals |
| issn | 2090-6609 2090-6617 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Immunology |
| spelling | doaj-art-8ea9eda6b69e45d2a167a96173121b402025-08-20T02:09:24ZengWileyCase Reports in Immunology2090-66092090-66172018-01-01201810.1155/2018/45202944520294Effective Immunotherapy in Bone Marrow Metastatic Melanoma Presenting with Disseminated Intravascular CoagulopathyBolanle Gbadamosi0Daniel Ezekwudo1Bhadresh Nayak2Zhou Yu3Sandra Gjorgova-Gjeorgjievski4Ming Xie5Colvin Robert6Ishmael Jaiyesimi7Marianne Huben8Beaumont Hospital, Oakland University School of Medicine, Department of Hematology and Oncology, Royal Oak, MI, USABeaumont Hospital, Oakland University School of Medicine, Department of Hematology and Oncology, Royal Oak, MI, USABeaumont Hospital, Oakland University School of Medicine, Department of Hematology and Oncology, Royal Oak, MI, USABeaumont Hospital, Oakland University School of Medicine, Department of Hematology and Oncology, Royal Oak, MI, USABeaumont Hospital, Oakland University School of Medicine, Department of Anatomic and Hematopathology, Royal Oak, MI, USABeaumont Hospital, Oakland University School of Medicine, Department of Anatomic and Hematopathology, Royal Oak, MI, USABeaumont Hospital, Oakland University School of Medicine, Department of Diagnostic Radiology and Molecular Imaging, Royal Oak, MI, USABeaumont Hospital, Oakland University School of Medicine, Department of Hematology and Oncology, Royal Oak, MI, USABeaumont Hospital, Oakland University School of Medicine, Department of Hematology and Oncology, Royal Oak, MI, USAMalignant melanoma is responsible for the majority of skin cancer deaths and is increasing in prevalence. Bone marrow (BM) involvement by melanoma is rare in the absence of widespread visceral disease. Here, we report the case of a 30-year-old female who presented to the hospital with back pain, low-grade fever, and easy bruising. She was found to be bicytopenic and in disseminated intravascular coagulopathy (DIC). Surprisingly, BM biopsy showed extensive involvement by metastatic malignant melanoma in the absence of visceral or brain metastasis. The unique presentation of this case and the challenge of management of a potentially treatable cancer in a critically ill patient are discussed, alongside a review of published cases of metastatic melanoma in the BM and an exploration of currently available treatment options. The excellent response of our patient to combined immune checkpoint inhibitors has yet to be paralleled in the available literature.http://dx.doi.org/10.1155/2018/4520294 |
| spellingShingle | Bolanle Gbadamosi Daniel Ezekwudo Bhadresh Nayak Zhou Yu Sandra Gjorgova-Gjeorgjievski Ming Xie Colvin Robert Ishmael Jaiyesimi Marianne Huben Effective Immunotherapy in Bone Marrow Metastatic Melanoma Presenting with Disseminated Intravascular Coagulopathy Case Reports in Immunology |
| title | Effective Immunotherapy in Bone Marrow Metastatic Melanoma Presenting with Disseminated Intravascular Coagulopathy |
| title_full | Effective Immunotherapy in Bone Marrow Metastatic Melanoma Presenting with Disseminated Intravascular Coagulopathy |
| title_fullStr | Effective Immunotherapy in Bone Marrow Metastatic Melanoma Presenting with Disseminated Intravascular Coagulopathy |
| title_full_unstemmed | Effective Immunotherapy in Bone Marrow Metastatic Melanoma Presenting with Disseminated Intravascular Coagulopathy |
| title_short | Effective Immunotherapy in Bone Marrow Metastatic Melanoma Presenting with Disseminated Intravascular Coagulopathy |
| title_sort | effective immunotherapy in bone marrow metastatic melanoma presenting with disseminated intravascular coagulopathy |
| url | http://dx.doi.org/10.1155/2018/4520294 |
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