Abstract
A newborn female child was born with a congenital pigment synthesizing melanoma of the scalp. Further workup revealed metastatic disease within the liver, lungs, and left tibia. Whole exome sequencing was performed on multiple samples that revealed one somatic mutation, lysine methyltransferase 2C (KMT2C), at low allelic frequency but no v-Raf murine sarcoma viral oncogene homolog B (BRAF), NF-1 mutation. Programmed death ligand 1 was moderately expressed. Treatment was initiated with the programmed cell death protein 1 inhibitor nivolumab. The patient tolerated this treatment well with minimal toxicity. She is now over a year out from initial diagnosis, continuing on nivolumab, with stable disease.
Keywords:
PD-1 inhibition; congenital; metastatic melanoma; pediatric; pigment synthesizing.
© 2017 Wiley Periodicals, Inc.
MeSH terms
-
Antibodies, Monoclonal / administration & dosage*
-
Female
-
Gene Expression Regulation, Neoplastic / drug effects
-
Head and Neck Neoplasms* / drug therapy
-
Head and Neck Neoplasms* / genetics
-
Head and Neck Neoplasms* / metabolism
-
Head and Neck Neoplasms* / pathology
-
Histone-Lysine N-Methyltransferase
-
Humans
-
Infant, Newborn
-
Melanoma* / drug therapy
-
Melanoma* / genetics
-
Melanoma* / metabolism
-
Melanoma* / pathology
-
Mutation*
-
Neoplasm Metastasis
-
Neoplasm Proteins / antagonists & inhibitors
-
Neoplasm Proteins / genetics
-
Neoplasm Proteins / metabolism
-
Nivolumab
-
Programmed Cell Death 1 Receptor / antagonists & inhibitors*
-
Programmed Cell Death 1 Receptor / biosynthesis
-
Skin Neoplasms* / drug therapy
-
Skin Neoplasms* / genetics
-
Skin Neoplasms* / metabolism
-
Skin Neoplasms* / pathology
Substances
-
Antibodies, Monoclonal
-
Neoplasm Proteins
-
PDCD1 protein, human
-
Programmed Cell Death 1 Receptor
-
Nivolumab
-
Histone-Lysine N-Methyltransferase