Primary Cutaneous Small/Medium CD4+ T-Cell Lymphoma Occurring During Treatment With Vemurafenib for Advanced Melanoma. (June 2015)

• Record Type: Journal Article
• Authors: Garrido, Maria C.; Riveiro-Falkenbach, Erica; Ruano, Yolanda; Ortiz, Pablo; Rodriguez-Peralto, Jose L.
• Is Part Of: American journal of dermatopathology. Volume 37:Number 6(2015)
• Publication Date: 2015-06
• Subjects: melanoma -- vemurafenib -- BRAF V600E mutation -- cutaneous lymphoma; Skin -- Diseases -- Periodicals; Histology, Pathological -- Periodicals; 616.50705
• DOI: 10.1097/DAD.0000000000000231
• Languages: English
• ISSNs: 0193-1091

Abstract

Abstract : Abstract: The discovery of BRAF mutations in 40%–60% of melanomas led to the development of BRAF inhibitors, which exhibit objective response in over 50% of patients. However, up to 98% of the patients develop at least 1 side effect. We report for the first time a patient with metastatic melanoma harboring BRAF V600E mutation that develops a primary, cutaneous small/medium CD4 + T-cell lymphoma secondarily to the treatment with vemurafenib. A 54-year-old man with a history of metastatic melanoma treated with the oral BRAF inhibitor vemurafenib presents, 4 months after the initiation of the treatment, with multiple, nodular firm nonulcerated lesions on his back. Two skin biopsies from the lesions revealed a primary, cutaneous small/medium CD4 + T-cell lymphoma. The extensive use of recently approved mutation-specific RAF inhibitors seems to be speeding up the emergence of unknown nonpreventable toxicities of these agents. Our patient developed a primary, cutaneous small/medium CD4 + T-cell lymphoma, which presented 4 months after the commencement of vemurafenib. Although no treatment interruption is normally required, a close monitoring of the patients with advanced melanomas treated with vemurafenib seems imperative to optimize the management strategies.