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NRAS Q61R-mutant mucosal melanoma with cardiac metastasis - a diagnostic challenge


MOJ Clinical & Medical Case Reports
Diana Zhang,1 Danai Dima,1 Xiao Hu,1 Joshua Dower,1 Andrew Soroka,2 Haihui Liao,3 Austin Turner,4 Yu Cao,5 Lori Pai,5

Abstract

We present this case report of a patient with NRAS Q61R-mutant melanoma, suspected to be mucosal melanoma of small bowel origin with cardiac, hepatic and pulmonary metastases. We focus on the unique manner of diagnosis (requiring the finding of a specific molecular signature via liquid biopsy in conjunction with tissue biopsy) and management of this rare cancer with first-line immunotherapy with dual checkpoint blockade followed by maintenance PD-1 inhibition, allowing the patient to have sustained clinical response at eight months since original diagnosis.

Keywords

mucosal melanoma, NRAS Q61R-mutant melanoma, liquid biopsy, immunotherapy, extra-cutaneous melanocytes, extra-cutaneous melanocytes mucosal melanoma

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