Melanoma oral metastático: tratamento com radioterapia e nivolumabe
DOI:
https://doi.org/10.11606/issn.1679-9836.v99i6p619-625Palavras-chave:
Melanoma, Imunoterapia, Nivolumabe, RadioterapiaResumo
INTRODUÇÃO: O Melanoma de Mucosa Oral (MMO) é uma neoplasia maligna rara, corresponde a cerca de 0,5% de todos os tumores orais. Este melanoma ocorre devido a proliferação atípica de melanócitos presentes no epitélio das mucosas do organismo. O tratamento é realizado por ressecção cirúrgica, quimioterapia e radioterapia como tratamento adjuvante. Nos casos com linfonodos metastáticos pode-se usar o tratamento adjuvante com imunoterapia. RELATO DE CASO: Paciente 83 anos, sexo masculino, teve como queixa principal tumoração de cor escura em gengiva, palato duro e seio maxilar direito, com linfonodos metastáticos cervicais e mediastinais e metástases pulmonares. Em 2015, iniciou tratamento com DTIC com resposta parcial e após um ano, iniciou a terapêutica com Imatinibe com resposta parcial e depois progressão da doença. Em 2016, iniciou tratamento com Nivolumabe e radioterapia local com IMRT. Apresentou remissão completa local e parcial sistêmica. Também apresentou como efeitos colaterais imunomediados insuficiência suprarrenal, hipotireoidismo, diabetes melitus e vitiligo em face e flanco esquerdo. Nosso relato tem como objetivo apresentar um caso de melanoma de mucosa oral na região da gengiva, palato e seio maxilar com metástases sistêmicas, tratado com Nivolumabe e radioterapia, e com isso comparar com outros relatos existentes na literatura e ressaltar as complicações da imunoterapia.
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Copyright (c) 2020 João Carlos Simões, Mateus Rocco, Beatriz Sayuri Nakamura
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