S Parakh1,2,3, M Goh4, M C Andrews1,2,5. 1. Medical Oncology Unit, Austin Health, Heidelberg, Vic., Australia. 2. Olivia Newton-John Cancer Research Institute, Heidelberg, Vic., Australia. 3. School of Cancer Medicine, La Trobe University, Vic., Australia. 4. Dermatology Unit, Austin Health, Heidelberg, Vic., Australia. 5. Department of Medicine, University of Melbourne, Parkville, Vic., Australia.
Abstract
WHAT IS KNOWN AND OBJECTIVE: Cutaneous toxicities are commonly seen with BRAF inhibitors, frequently involving painful hyperkeratosis of the feet. We illustrate an unexpected diagnosis of extensive bilateral pedal Kaposi sarcoma masquerading as BRAF inhibitor-related toxicity in a patient treated with dabrafenib for metastatic melanoma. CASE SUMMARY: A HIV-negative, non-diabetic, Italian man with a history of myasthenia gravis and metastatic melanoma presented with enlarging macular/plaque-like rash on his feet preceded by bilateral plantar shooting pains. The rash progressed in the context of acute-on-chronic immunosuppression and was initially thought due to commencement of the BRAF inhibitor (BRAFi) dabrafenib. Histopathological findings from skin biopsies revealed Kaposi sarcoma. The patient was continued on dabrafenib and received superficial radiotherapy to the feet with prompt relief of pain. WHAT IS NEW AND CONCLUSION: This case illustrates the diagnostic pitfalls in patients treated with targeted therapies and highlights the importance of broad differentials for unusual presentations and early biopsy.
WHAT IS KNOWN AND OBJECTIVE:Cutaneous toxicities are commonly seen with BRAF inhibitors, frequently involving painful hyperkeratosis of the feet. We illustrate an unexpected diagnosis of extensive bilateral pedal Kaposi sarcoma masquerading as BRAF inhibitor-related toxicity in a patient treated with dabrafenib for metastatic melanoma. CASE SUMMARY: A HIV-negative, non-diabetic, Italian man with a history of myasthenia gravis and metastatic melanoma presented with enlarging macular/plaque-like rash on his feet preceded by bilateral plantar shooting pains. The rash progressed in the context of acute-on-chronic immunosuppression and was initially thought due to commencement of the BRAF inhibitor (BRAFi) dabrafenib. Histopathological findings from skin biopsies revealed Kaposi sarcoma. The patient was continued on dabrafenib and received superficial radiotherapy to the feet with prompt relief of pain. WHAT IS NEW AND CONCLUSION: This case illustrates the diagnostic pitfalls in patients treated with targeted therapies and highlights the importance of broad differentials for unusual presentations and early biopsy.
Authors: Elizabeth K Cahoon; Eric A Engels; D Michal Freedman; Mary Norval; Ruth M Pfeiffer Journal: J Natl Cancer Inst Date: 2016-12-31 Impact factor: 13.506
Authors: Marios Grigoriou; Konstantinia E Kofina; Aristeidis Ioannidis; Domniki K Gerasimidou; Christoforos Efthymiadis; Thomas Zaramboukas Journal: Am J Case Rep Date: 2017-07-26