A Rare Thyroid Metastasis from Uveal Melanoma and Response to Immunotherapy Agents.
Thyroid metastasis is a rare occurrence with cutaneous melanoma and even more uncommon with uveal melanoma. The management of such metastasis is uncertain due to its infrequency and, in the era of immunotherapy, the effect of these novel drugs on uncommon metastasis, such as to the thyroid, is unknown. We report the rare case of a thyroid metastasis in a patient diagnosed with ocular melanoma initially managed with enucleation. Metastatic disease developed in the lung and thyroid gland. The case patient received the immunotherapy ipilimumab with stable disease in the thyroid and progressive disease elsewhere. The patient was then further treated with a second immunotherapy agent, pembrolizumab, and remains with stable disease one year later. We discuss the current literature on thyroid metastases from all causes and the optimal known management strategies. Furthermore, we provide an original report on the response of this disease to the novel immunomodulators, ipilimumab, and pembrolizumab with stable disease four years after initial diagnosis of ocular melanoma.
Department of Medical Oncology, Cork University Hospital, Wilton, Co. Cork, Ireland.
Dearbhaile Catherine
DC
Collins
Department of Histopathology, Cork University Hospital, Wilton, Co. Cork, Ireland.
Ruben
R
Yela
Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin 2, Ireland.
Noel
N
Horgan
Department of Medical Oncology, Cork University Hospital, Wilton, Co. Cork, Ireland.
Derek Gerard
DG
Power