2017 Volume 32 Issue 1 Pages 76-81
A 48-year-old man visited our hospital with a black ulcerated nodule on his right upper flank, which developed from a large melanocytic-nevus present since childhood. His right axillary lymph node was swollen. He was diagnosed with malignant melanoma ; wide excision and axillary lymph node dissection and postoperative radiotherapy to his right axilla were performed. In April 2015, PET-CT revealed metastases to the bone, lung, and gallbladder. His melanoma harbored a BRAF mutation ; therefore, vemurafenib was administered. Although he had a renal dysfunction due to gout, it was controlled by a dose reduction and holding treatment of vemurafenib, in addition to hydration. After administration of vemurafenib, he achieved stable disease for several months. In September, the patient experienced confusion. Multiple brain metastases were detected by CT and MRI. Stereotactic irradiation was administered during a 1.5-day vemurafenib withdrawal period. After irradiation, the confusion improved. Further, CT scans did not reveal radiation necrosis or new brain abnormalities.[Skin Cancer (Japan) 2017 ; 32 : 76-81]
