Persistent response to vemurafenib in metastatic ameloblastoma with BRAF mutation: a case report

J Med Case Rep. 2019 Jul 25;13(1):245. doi: 10.1186/s13256-019-2140-6.

Abstract

Background: Ameloblastomas are uncommon locally aggressive tumors of odontogenic epithelium that rarely metastasize. Currently, there is no standard of care for the metastatic forms. Several studies have shown that ameloblastomas frequently have a BRAF mutation.

Case presentation: We report a case of a 33-year-old Caucasian woman with ameloblastoma diagnosed 30 years ago who developed lung metastasis 19 years ago. Systemic oral treatment with vemurafenib, a BRAF inhibitor, was initiated 28 months ago within the AcSé French basket clinical trial of vemurafenib.

Conclusions: The patient has shown a durable clinical, functional, and radiographic partial response with vemurafenib. These observations suggest the possibility of introducing neoadjuvant and/or adjuvant targeted therapy in locally advanced ameloblastoma to improve outcome. BRAF inhibition has proved to be an efficient strategy in patients with a BRAF-mutated ameloblastoma.

Keywords: Ameloblastoma; BRAF; Case report; Metastatic; Vemurafenib.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Ameloblastoma* / drug therapy
  • Ameloblastoma* / pathology
  • Ameloblastoma* / secondary
  • Female
  • Humans
  • Jaw Neoplasms / surgery
  • Lung Neoplasms* / drug therapy
  • Lung Neoplasms* / pathology
  • Lung Neoplasms* / secondary
  • Mutation
  • Protein Kinase Inhibitors / administration & dosage*
  • Proto-Oncogene Proteins B-raf
  • Vemurafenib / administration & dosage*

Substances

  • Protein Kinase Inhibitors
  • Vemurafenib
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf