BRAF inhibitor-induced panniculitis in patients treated for stage IV metastatic melanoma: a case series

Skeletal Radiol. 2021 Jun;50(6):1257-1262. doi: 10.1007/s00256-020-03665-9. Epub 2020 Nov 9.

Abstract

BRAF and MEK inhibitor combination therapy is the standard treatment for patients with BRAF V600E mutant metastatic melanoma. Neutrophilic panniculitis is a known rare complication of BRAF inhibitor therapy and can act as a potential mimic of melanoma metastases on 18F-FDG PET/CT. In this case series, we present three cases of BRAF inhibitor-induced panniculitis in patients being treated for BRAF-mutant metastatic melanoma and emphasize the use of ultrasound to differentiate between panniculitis lesions, which are typically ill-defined echogenic masses and subcutaneous soft tissue melanoma metastases, which present as hypoechoic vascular masses.

Keywords: BRAF; Diagnostic ultrasound; Melanoma; PET/CT; Panniculitis.

MeSH terms

  • Fluorodeoxyglucose F18
  • Humans
  • Melanoma* / drug therapy
  • Mutation
  • Panniculitis* / chemically induced
  • Panniculitis* / diagnostic imaging
  • Positron Emission Tomography Computed Tomography
  • Proto-Oncogene Proteins B-raf / genetics
  • Skin Neoplasms* / diagnostic imaging
  • Skin Neoplasms* / drug therapy

Substances

  • Fluorodeoxyglucose F18
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf