Ruptured hepatic metastases of cutaneous melanoma during treatment with vemurafenib: an autopsy case report

• DOI: 10.1186/s12907-015-0015-3
• Publication Date: 2015-09-03T10:34:45Z
• Authors: Takuto Nosaka; Katsushi Hiramatsu; Tomoyuki Nemoto; Yasushi Saito; Yoshihiko Ozaki; Kazuto Takahashi; Tatsushi Naito; Kazuya Ofuji; Hidetaka Matsuda; Masahiro Ohtani; Hiroyuki Suto; Yoshiaki Imamura; Yasunari Nakamoto
• Keywords: 03 medical and health sciences; Histology; 0302 clinical medicine; Case Report; Pathology and Forensic Medicine; 3. Good health

The spontaneous rupture of hepatic metastases is rare compared to that primary tumors. In addition, vemurafenib, a selective inhibitor the mutant BRAF protein or gene product, has been reported be extremely effective in patients with metastatic melanoma who harbor V600E mutation.A 44-year-old female had previously undergone surgery for resection malignant lower right leg. Four years later, became apparent, and transcatheter arterial embolization (TAE) was performed. Then she underwent treatment vemurafenib. size markedly decreased. Two months they enlarged rapidly ruptured, requiring emergency TAE. However, patient developed hemorrhagic shock died renewed intra-abdominal bleeding on 26th postoperative day.This case ruptured during Postmortem examination immunohistochemical analysis indicated reactivation mitogen-activated kinase pathway tumor, suggesting secondary resistance vemurafenib as possible underlying mechanism.