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New treatment options like the BRAF inhibitors have been established for immunocompetent patients with metastatic melanoma, but experience in organ transplant recipients is lacking.
A female double lung transplant recipient in her 60s with a standard triple immunosuppressive regimen (cyclosporine, mycophenolate mofetil, prednisolone) and chronic lung allograft dysfunction was diagnosed with metastatic melanoma and pulmonary (Figure 1A), mediastinal, hepatic, osseous, subcutaneous, and cerebral metastases (Figure 2A). A primary tumor could not be detected, and tumor cells harbored a BRAF V600E mutation. Tumor marker S100 was elevated to 0.545 µg/L (reference value, <0.105 µg/L).
Afshar K, David S, Fuehner T, Gottlieb J, Gutzmer R. BRAF Inhibition in a Lung Transplant Recipient With Metastatic Melanoma. JAMA Dermatol. 2016;152(2):228-230. doi:10.1001/jamadermatol.2015.2910