Case report: differential genomics and evolution of a meningeal melanoma treated with ipilimumab and nivolumab

Primary melanocytic tumors of the CNS are extremely rare conditions, encompassing different disease processes including meningeal melanoma and meningeal melanocytosis. Its incidence range between 3-5%, with approximately 0.005 cases per 100,000 people. Tumor biological behavior is commonly aggressiv...

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Autores:
Burgos, Remberto
Santoyo, Nicolas
Ruíz-Patiño, Alejandro
Cure-Casilimas, Juanita
Rojas, Leonardo
Ricaurte, Luisa María
Muñoz, Álvaro
Ordoñez, Camila
Sotelo, Carolina
Rodríguez, July
Tipo de recurso:
Article of journal
Fecha de publicación:
2022
Institución:
Universidad El Bosque
Repositorio:
Repositorio U. El Bosque
Idioma:
eng
OAI Identifier:
oai:repositorio.unbosque.edu.co:20.500.12495/6769
Acceso en línea:
http://hdl.handle.net/20.500.12495/6769
https://doi.org/10.3389/fonc.2021.691017
Palabra clave:
Melanoma
Radiocirugía
Inmunoterapia
Genómica
Tumor melanocítico meníngeo
melanoma
radiosurgery
immunotherapy
genomics
GNAQ
TERT
meningeal melanocytic tumor
Rights
openAccess
License
Atribución 4.0 Internacional
Description
Summary:Primary melanocytic tumors of the CNS are extremely rare conditions, encompassing different disease processes including meningeal melanoma and meningeal melanocytosis. Its incidence range between 3-5%, with approximately 0.005 cases per 100,000 people. Tumor biological behavior is commonly aggressive, with poor prognosis and very low survivability, and a high recurrence rate, even after disease remission with multimodal treatments. Specific genetic alterations involving gene transcription, alternative splicing, RNA translation, and cell proliferation are usually seen, affecting genes like BRAF, TERT, GNAQ, SF3B1, and EIF1AX. Here we present an interesting case of a 59-year-old male presenting with neurologic symptoms and a further confirmed diagnosis of primary meningeal melanoma. Multiple therapy lines were used, including radiosurgery, immunotherapy, and chemotherapy. The patient developed two relapses and an evolving genetic makeup that confirmed the disease’s clonal origin. We also provide a review of the literature on the genetic basis of primary melanocytic tumors of the CNS.