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Management of intramuscular melanoma metastases to the psoas
  1. Charles Joseph Cash1,
  2. Joseph Matthew Pearson2,
  3. Clara Milikowski3,
  4. Lynn Feun4,
  5. Chad Ritch5 and
  6. Mecker G Möller6,7
  1. 1 Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
  2. 2 Gynecologic Oncology, University of Miami Miller School of Medicine, Miami, Florida, USA
  3. 3 Department of Pathology and Laboratory Medicine, University of Miami School of Medicine, Miami, Florida, USA
  4. 4 Department of Hematology and Oncology, University of Miami Miller School of Medicine, Miami, Florida, USA
  5. 5 Department of Urologic Oncology, University of Miami Miller School of Medicine, Miami, Flordia, USA
  6. 6 University of Miami Miller School of Medicine, Miami, Florida, USA
  7. 7 Surgical Oncology, The University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
  1. Correspondence to Charles Joseph Cash; cjc636{at}med.miami.edu

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.

  • Surgical oncology
  • General surgery
  • Surgery
  • Skin cancer

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Footnotes

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: Conceptualisation: CJC, MGM. Drafting of text: CJC, JMP, CR, CM, LF, MGM. Sourcing and editing of clinical images: all authors. Investigation results: CJC, JMP, CR, CM, LF, MGM. Drawing original diagrams and algorithms: CJC, JMP, CR, CM, LF, MGM. Critical revision for important intellectual component: CJC, JMP, CR, CM, LF, MGM. The following authors gave final approval of the manuscript: CJC, JMP, CR, CM, LF, MGM.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.