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Complete response of stage IV anal mucosal melanoma expressing KIT Val560Asp to the multikinase inhibitor sorafenib

Nature Clinical Practice Oncology volume 5, pages 737–740 (2008)Cite this article

Abstract

Background A 79-year-old man presented to his primary care physician with a 2-month history of pruritus ani and a pigmented nodular lesion was discovered in the posterior rectum. The patient had no other symptoms, or any family history of malignancy.

Investigations Physical examination; excisional biopsy; CT scan of the chest, abdomen and pelvis; lung biopsy; blood tests; tumor immunohistochemistry for KIT, vascular endothelial growth factor platelet-derived growth factor receptor α and β, and mismatch-repair proteins MLH1, MSH2, and MSH6; and KIT and BRAF tumor genotyping.

Diagnosis Stage IV M1b metastatic anal mucosal melanoma.

Management Wide local excision with mucosal advancement of the rectal wall, external-beam radiation, and sorafenib–temozolomide therapy.

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Figure 1: Hematoxylin and eosin and immunohistochemical staining (inset) of the patient's primary tumor.
Figure 2: Sequence analysis of KIT from the patient's tumor DNA.
Figure 3: CT scan of the patient's chest before and after sorafenib and temozolomide therapy.

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Acknowledgements

Charles P Vega, University of California, Irvine, CA, is the author of and is solely responsible for the content of the learning objectives, questions and answers of the Medscape-accredited continuing medical education activity associated with this article.

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Authors and Affiliations

  1. A Quintás-Cardama is a Hematology/Oncology Fellow in the Division of Cancer Medicine, SE Woodman is a Hematology/Oncology Fellow in the Division of Cancer Medicine, K Kim is an Associate Professor in the Department of Melanoma Medical Oncology, and P Hwu is Chairman of the Department of Melanoma Medical Oncology, AJ Lazar is an Assistant Professor of Pathology in the Sarcoma Research Center, M Ross is a Professor in Surgical Oncology, all at the MD Anderson Cancer Center, Houston, TX, USA.,

    Alfonso Quintás-Cardama, Alexander J Lazar, Scott E Woodman, Kevin Kim, Merrick Ross & Patrick Hwu

Authors
  1. Alfonso Quintás-Cardama
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  2. Alexander J Lazar
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  6. Patrick Hwu
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Correspondence to Patrick Hwu.

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Quintás-Cardama, A., Lazar, A., Woodman, S. et al. Complete response of stage IV anal mucosal melanoma expressing KIT Val560Asp to the multikinase inhibitor sorafenib. Nat Rev Clin Oncol 5, 737–740 (2008). https://doi.org/10.1038/ncponc1251

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