Dupuytren’s contractures associated with the BRAF inhibitor vemurafenib: a case report

Journal of Medical Case Reports

Daniel Alberto Vorobiof¹  Sze Wai Chan¹ 

[1] Sandton Oncology Centre, 159 Rivonia Road, Morningside, Sandton, Johannesburg 2199, Gauteng, South Africa

关键词: Vemurafenib;    Dupuytren’s contracture;    Cutaneous malignant melanoma;    BRAF V600 mutation;   

Others  :  1231439
DOI  :  10.1186/s13256-015-0634-4

 received in 2014-11-03, accepted in 2015-06-15,  发布年份 2015

【 摘 要 】

Introduction

Two previous cases of the development of Dupuytren’s contractures were reported in association with BRAF inhibitor treatment for BRAF V600E mutation-positive metastatic melanoma and metastatic papillary thyroid carcinoma. We reported on a third case with a slower onset of presentation.

Case presentation

A 66-year-old white man was diagnosed with a BRAF V600E mutated metastatic cutaneous melanoma. He was commenced on oral vemurafenib 960mg twice daily. A marked response was achieved for his metastatic disease. He noticed a change of his hair characteristics and a feeling of “lumps” in both palms by 6 months. By 9 months, classical Dupuytren’s contracture was apparent.

Conclusions

Dupuytren’s contracture is not a known side effect of BRAF inhibitor treatment. The timeline for the development of Dupuytren’s contracture on BRAF inhibitor treatment is not well defined. Although the etiology of Dupuytren’s contracture is unknown, an increase in tumor necrosis factor has been demonstrated to be a possible mechanism. BRAF inhibition has been shown to increase immune reaction in the tumor microenvironment and is associated with high serum tumor necrosis factor level. We propose that an increased level of tumor necrosis factor associated with BRAF inhibition may increase the risk of the development of Dupuytren’s contractures.

【 授权许可】

   
2015 Chan and Vorobiof.

【 图 表 】

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