Melanoma is a malignant neoplasm that affects the melanocytes. Its treatment is based on cancer staging. In immunotherapy, it can be pointed out the ipilimumab, used in the systemic therapy for unresectable and/or met...Melanoma is a malignant neoplasm that affects the melanocytes. Its treatment is based on cancer staging. In immunotherapy, it can be pointed out the ipilimumab, used in the systemic therapy for unresectable and/or metastatic melanoma in the first or the second line treatment with increased survival. However, limiting toxicity and the low complete response discourage its use in the elderly patients. The aim of this study is to report the case of an 83-year-old man, white, with scalp melanoma measuring 3.5 cm in its major axis. After two resections was verified that the deep margin was involved, making the lesions unresectable. The evaluation of distant metastasis, by skull, chest and abdomen CT-scan （computed tomography-scan）, was performed and did not detect the presence of any metastatic loci. The patient underwent the first cycle of chemotherapy with DTIC （dacarbazine） protocol. After the first cycle, the medication was discontinued due to significant myelotoxicity and Grade 3 thrombocytopenia. Underwent second line treatment with ipilimumab by four cycles. After this, the patient follow with complete local response, asymptomatic, with no signs of local recurrence or distant metastasis site, and no limiting toxicity during and after a year of treatment with ipilimumab. Thus, it is possible to suggest that the use of ipilimumab isolatedly as a second line treatment may have a good response even in elderly patients.展开更多
文摘Melanoma is a malignant neoplasm that affects the melanocytes. Its treatment is based on cancer staging. In immunotherapy, it can be pointed out the ipilimumab, used in the systemic therapy for unresectable and/or metastatic melanoma in the first or the second line treatment with increased survival. However, limiting toxicity and the low complete response discourage its use in the elderly patients. The aim of this study is to report the case of an 83-year-old man, white, with scalp melanoma measuring 3.5 cm in its major axis. After two resections was verified that the deep margin was involved, making the lesions unresectable. The evaluation of distant metastasis, by skull, chest and abdomen CT-scan （computed tomography-scan）, was performed and did not detect the presence of any metastatic loci. The patient underwent the first cycle of chemotherapy with DTIC （dacarbazine） protocol. After the first cycle, the medication was discontinued due to significant myelotoxicity and Grade 3 thrombocytopenia. Underwent second line treatment with ipilimumab by four cycles. After this, the patient follow with complete local response, asymptomatic, with no signs of local recurrence or distant metastasis site, and no limiting toxicity during and after a year of treatment with ipilimumab. Thus, it is possible to suggest that the use of ipilimumab isolatedly as a second line treatment may have a good response even in elderly patients.
