Bilateral ovarian metastatic melanoma: a case report in a young patient with mutated BRAF

Abstract

Introduction: Cutaneous melanoma stands as the leading cause of deaths related to skin neoplasms. Medicinal advancements have played a crucial role in reducing mortality, particularly in patients with BRAF gene mutations, guiding specific therapies for this oncogene. Case report: A 27-year-old woman diagnosed with melanoma in the right upper limb, treated with limb amputation. After four years, she was transferred to another service due to complaints of severe headache, nausea, progressive decrease in visual acuity, vomiting, and weight loss in the last two months. Imaging exams revealed multiple nodules in the brain region, and bilateral ovarian masses were also identified. Histological and immunohistochemical analysis, after surgical resection, confirmed metastatic origin in both locations. Furthermore, a molecular study of the BRAF gene revealed the presence of mutation in the patient. The medical team's therapeutic plan included the administration of Dabrafenib and Trametinib, agents targeting anti-BRAF therapy; however, the patient died during the waiting period for treatment. Discussion: Among the sites of cutaneous melanoma metastasis, gynecological organs stand out in women of childbearing age. BRAF gene mutation is frequently associated with the diagnosis of melanoma in young patients of Caucasian descent and with high sun exposure. In metastatic cases, targeted therapies have shown efficacy when initiated early. Conclusion: Melanoma remains a challenging disease, requiring a multidisciplinary approach for the evaluation of disseminated cases, demanding rapid and individualized intervention.