A case of acute paraneoplastic neurological syndrome in BRAF mutant metastatic melanoma
- 1 August 2016
- journal article
- case report
- Published by Ovid Technologies (Wolters Kluwer Health) in Melanoma Research
- Vol. 26 (4), 425-428
- https://doi.org/10.1097/cmr.0000000000000264
Abstract
A 58-year-old man with indolent metastatic BRAF mutant melanoma presented with several days' history of progressive ataxia and dysdiadochokinesia. His PET/computed tomography restaging scan indicated two new fluorine-18-fluorodeoxyglucose-avid mesenteric lymph nodes. Meanwhile, his MRI brain and whole spine were within normal limits. A lumbar puncture indicated an elevated protein level with a normal cell count and negative paraneoplastic antibodies. Because of the lack of an alternative differential, the diagnosis of paraneoplastic syndrome was made. He was started on high-dose corticosteroids as well as dabrafenib and trametinib. Despite this, his neurological symptoms continued to progress. Consequently, he was trialed on a course of intravenous immunoglobulin, which stabilized his symptoms. He continued to improve over several weeks, with near-complete resolution of all his neurological symptoms, and showed a complete radiological response of his disease. To our knowledge, this is the first reported case of paraneoplastic neurological syndrome with mixed neurology associated with BRAF mutant cutaneous melanoma that responded to BRAF targeted therapy.Keywords
This publication has 19 references indexed in Scilit:
- Encéphalite limbique : une nouvelle manifestation auto-immune paranéoplasique associée au mélanome métastatique ?Annales de Dermatologie et de Vénéréologie, 2013
- Melanoma-Associated RetinopathyJAMA Ophthalmology, 2009
- Recognition of a Ubiquitous Self Antigen by Prostate Cancer-Infiltrating CD8 + T LymphocytesScience, 2008
- Paraneoplastic syndrome in vaginal melanoma: a case report and review of the literatureInternational Journal of Gynecologic Cancer, 2007
- Paraneoplastic neurological syndromesOrphanet Journal of Rare Diseases, 2007
- Managing Paraneoplastic Neurological DisordersThe Oncologist, 2006
- Dermatomyositis associated with malignant melanoma—A marker of poor prognosis?Journal of the American Academy of Dermatology, 2006
- Molecular mimicry in chronic inflammatory demyelinating polyneuropathy and melanomaNeurology, 1998
- Chronic inflammatory demyelinating polyneuropathy associated with malignant melanomaNeurology, 1996
- Myelin‐Associated Glycoprotein Shares an Antigenic Determinant with a Glycoprotein of Human Melanoma CellsJournal of Neurochemistry, 1986