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Case Reports in Immunology
Volume 2018, Article ID 4520294, 8 pages
https://doi.org/10.1155/2018/4520294
Case Report

Effective Immunotherapy in Bone Marrow Metastatic Melanoma Presenting with Disseminated Intravascular Coagulopathy

1Beaumont Hospital, Oakland University School of Medicine, Department of Hematology and Oncology, Royal Oak, MI, USA
2Beaumont Hospital, Oakland University School of Medicine, Department of Anatomic and Hematopathology, Royal Oak, MI, USA
3Beaumont Hospital, Oakland University School of Medicine, Department of Diagnostic Radiology and Molecular Imaging, Royal Oak, MI, USA

Correspondence should be addressed to Bolanle Gbadamosi; ude.tnomuaeb@isomadabg.elnalob

Received 10 October 2017; Accepted 27 December 2017; Published 12 February 2018

Academic Editor: Rajni Rani

Copyright © 2018 Bolanle Gbadamosi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Malignant melanoma is responsible for the majority of skin cancer deaths and is increasing in prevalence. Bone marrow (BM) involvement by melanoma is rare in the absence of widespread visceral disease. Here, we report the case of a 30-year-old female who presented to the hospital with back pain, low-grade fever, and easy bruising. She was found to be bicytopenic and in disseminated intravascular coagulopathy (DIC). Surprisingly, BM biopsy showed extensive involvement by metastatic malignant melanoma in the absence of visceral or brain metastasis. The unique presentation of this case and the challenge of management of a potentially treatable cancer in a critically ill patient are discussed, alongside a review of published cases of metastatic melanoma in the BM and an exploration of currently available treatment options. The excellent response of our patient to combined immune checkpoint inhibitors has yet to be paralleled in the available literature.