Onkologie. 2025:19(2):100-103 | DOI: 10.36290/xon.2025.020

Patient with primary metastasizing anorectal mucosal melanoma

Linda Řandová¹, Ivana Krajsová¹, Miroslav Důra^{1, 2}

¹ Dermatovenerologická klinika 1. LF UK a VFN, Praha

² Bioptická laboratoř, s. r. o., Plzeň

The presented case report describes the case of a patient with mucosal primary metastasizing malignant melanoma of the anorectum. Due to the synchronous generalization to the lymph nodes and lungs and therefore the impossibility of a curative surgical or radiotherapy solution, the patient was treated with several lines of systemic treatment. In accordance with guidelines and for BRAF negativity, combined immunotherapy with ipilimumab and nivolumab was indicated in the 1st line of treatment. Subsequently, due to repeated progression of the disease, the patient completed two more lines of conventional chemotherapy and then, regarding metastatic spread to the brain, three more cycles of temozolomide treatment. Brain metastases were treated with the Leksell Gamma Knife (LGN), later for further progression the palliative whole brain radiotherapy (WBRT) was used. At the end of her life, the patient underwent palliative radiotherapy of the primary anorectal lesion with the aim of relieving the bothersome symptoms, she used a wound healing clinic and supportive care through a palliative clinic, later a home hospice. The patient died 33 months after the diagnosis of metastatic melanoma and 12 months after the diagnosis of brain metastases.

Keywords: metastatic mucosal melanoma, immunotherapy, ipilimumab, nivolumab, dacarbazine, temozolomide, brain metastases.

Accepted: April 25, 2025; Published: May 2, 2025  Show citation