Melanoma in multiple sclerosis treated with natalizumab: causal association or coincidence?
We report a relapsing-remitting multiple sclerosis patient who received monthly intravenous natalizumab. After the fifth dose, the patient had a change in a long-standing mole. Ten months later, the mole became ulcerative and was ablated. Histological examination identified a spreading melanoma reaching the lower dermis (Clark level IV). Considering that at the moment the incidence of melanoma is estimable as about 5 per 100,000 multiple sclerosis person-years treated with natalizumab, and that, in the general population, the incidence of melanoma per 100,000 person-years is more than 10, we may speculate that the occurrence of melanoma during natalizumab treatment in multiple sclerosis is purely a coincidence.
Bergamaschi
Roberto
R
Multiple Sclerosis Center, Neurological Institute Mondino of Pavia, Italy. roberto.bergamaschi@mondino.it
Montomoli
Cristina
C
D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D005260:Female; D006801:Humans; D008545:Melanoma / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy*; D000069442:Natalizumab; D012307:Risk Factors; D012878:Skin Neoplasms / Q000209:etiology* / Q000473:pathology / Q000601:surgery
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000069442:Natalizumab