Salcedo SI, Noguez RA, López ZL, Martínez-Herrera JF

Language: Spanish
References: 20
Page: 288-291
PDF size: 248.69 Kb.

ABSTRACT

The melanoma represents less than 5% of skin tumors. In advanced stages the prognosis is poor, overall survival reaches 6-9 months. Because of the introduction of immune checkpoint blockers the landscape of these patients has changed, pseudoprogression is a rare type of response in these patients and represents a challenge for the medical oncologist. Case report: An 80-year-old woman with nodular melanoma on the left leg, Breslow 4.5 mm, Clark IV, clinical stage IIB, recurrent metastatic in left pretibial lymph node, with a disease-free period of 15 months. Treatment at recurrence was surgical control; nevertheless, post-surgical imaging studies showed local and pulmonary tumor activity, therefore pembrolizumab-based immunotherapy was started. At fourth cycle, she presented an increase in the longitudinal diameter and elevation of the lesions that were classified as pseudoprogression, so she continued the treatment. Four applications later, the diameter of the lesions decreased. Subsequently, the lung lesion was controlled with radiosurgery. At this time, the patient has received 22 cycles and continues with stable disease. Pseudoprogression is a type of response that we must learn to evaluate in patients with melanoma undergoing immunotherapy, before considering a change in drugs.

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