Management of intramuscular melanoma metastases to the psoas

BMJ Case Rep. 2024 Jun 5;17(6):e257500. doi: 10.1136/bcr-2023-257500.

Abstract

We detail a case of a woman in her 40s with isolated melanoma skeletal muscle metastasis (MSMM) to the right psoas muscle. This patient underwent R0 surgical resection through a novel pelvic approach. She received subsequent adjuvant immunotherapy with Braftovi/Mektov along with adjuvant radiation. She is currently disease free at 9 months post surgery. Here, we describe our novel surgical approach including description of the tumour pathology. We explain our multidisciplinary management of MSMM consisting of a multidisciplinary surgical approach by surgical oncology, gynecological oncology and urology as well as multidisciplinary medical management by oncology, radiation oncology and pathology. Finally, we discuss best current options for therapeutic management.

Keywords: General surgery; Skin cancer; Surgery; Surgical oncology.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Female
  • Humans
  • Melanoma* / pathology
  • Melanoma* / secondary
  • Melanoma* / therapy
  • Muscle Neoplasms* / diagnostic imaging
  • Muscle Neoplasms* / secondary
  • Muscle Neoplasms* / therapy
  • Psoas Muscles* / diagnostic imaging
  • Psoas Muscles* / pathology
  • Skin Neoplasms / pathology
  • Skin Neoplasms / secondary