{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T04:59:57Z","timestamp":1781067597182,"version":"3.54.1"},"reference-count":54,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with melanoma frequently develop metastases, and managing these cases, especially aggressive, rare types such as pancreatic metastasis, remains challenging. To date, no consensus on treatment has been reached.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      This study presents an uncommon case of a 55-year-old man with rapidly progressive metastatic melanoma following initial lower-extremity melanoma resection. Within 5 months postoperatively, he developed widespread metastases, including lesions in the chest, back, calves, axilla, pancreas, and spleen, an exceptionally rare presentation. The patient received various treatment regimens, including toripalimab monotherapy, combination therapy with anlotinib, and combination therapy with temozolomide. Ultimately, surgical resection of the pancreatic and spleen metastases revealed a\n                      <jats:italic>BRAF<\/jats:italic>\n                      V600 mutation, permitting successful transition to targeted therapy with dabrafenib plus trametinib. As of the most recent follow-up on March 6, 2025, the patient remains stable with long-term survival.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case report, along with the subsequent literature review, emphasizes the need for continued treatment and vigilance of molecular monitoring in patients with advanced melanoma, as well as the critical role of multidisciplinary team collaboration in managing complex metastases. Surgical resection and targeted therapy might yield favorable outcomes for select patients with melanoma and pancreatic and splenic metastases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1736458","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T04:29:07Z","timestamp":1781065747000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Multimodal treatment and long-term survival in a rare case of melanoma with pancreatic and splenic metastases: a case report and literature review"],"prefix":"10.3389","volume":"16","author":[{"given":"Yanhua","family":"Mou","sequence":"first","affiliation":[{"name":"Department of Oncology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science","place":["Xiangyang, Hubei, China"]},{"name":"Institute of Oncology, Hubei University of Arts and Science","place":["Xiangyang, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Oncology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science","place":["Xiangyang, Hubei, China"]},{"name":"Institute of Oncology, Hubei University of Arts and Science","place":["Xiangyang, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Oncology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science","place":["Xiangyang, Hubei, China"]},{"name":"Institute of Oncology, Hubei University of Arts and Science","place":["Xiangyang, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Oncology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science","place":["Xiangyang, Hubei, China"]},{"name":"Institute of Oncology, Hubei University of Arts and Science","place":["Xiangyang, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Oncology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science","place":["Xiangyang, Hubei, China"]},{"name":"Institute of Oncology, Hubei University of Arts and Science","place":["Xiangyang, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lichao","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Pathology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science","place":["Xiangyang, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingfeng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Oncology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science","place":["Xiangyang, Hubei, China"]},{"name":"Institute of Oncology, Hubei University of Arts and Science","place":["Xiangyang, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1615\/CritRevEukaryotGeneExpr.2020028454","article-title":"Malignant melanoma: Skin cancer-diagnosis, prevention, and treatment","volume":"30","author":"Ahmed","year":"2020","journal-title":"Crit Rev Eukaryot Gene Expr"},{"key":"B2","doi-asserted-by":"publisher","first-page":"794","DOI":"10.1016\/j.arcmed.2022.11.008","article-title":"Immunotherapy options for acral melanoma, a fast-growing but neglected Malignancy","volume":"53","author":"Gaj\u00f3n","year":"2022","journal-title":"Arch Med Res"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.14218\/CSP.2024.00019","article-title":"Age-period-cohort analysis of cutaneous Malignant melanoma incidence in the United States from 1987 to 2016","volume":"3","author":"Du","year":"2024","journal-title":"Cancer Screen Prev"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3390\/cancers17172920","article-title":"Melanoma skin cancer: A comprehensive review of current knowledge","volume":"17","author":"Caraviello","year":"2025","journal-title":"Cancers (Basel)"},{"key":"B5","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.det.2022.07.007","article-title":"Targeted therapy and immunotherapy in melanoma","volume":"41","author":"Lazaroff","year":"2023","journal-title":"Dermatol Clin"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1103782","article-title":"Improved survival with vemurafenib in melanoma with BRAF V600E mutation","volume":"364","author":"Chapman","year":"2011","journal-title":"N Engl J Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1111\/pcmr.12847","article-title":"Targeted therapy and immunotherapy: Emerging biomarkers in metastatic melanoma","volume":"33","author":"LoRusso","year":"2020","journal-title":"Pigment Cell Melanoma Res"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(16)30122-x","article-title":"Cobimetinib combined with vemurafenib in advanced BRAF(V600)-mutant melanoma (coBRIM): updated efficacy results from a randomised, double-blind, phase 3 trial","volume":"17","author":"Ascierto","year":"2016","journal-title":"Lancet Oncol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(12)60868-x","article-title":"Dabrafenib in BRAF-mutated metastatic melanoma: a multicentre, open-label, phase 3 randomised controlled trial","volume":"380","author":"Hauschild","year":"2012","journal-title":"Lancet"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(15)60898-4","article-title":"Dabrafenib and trametinib versus dabrafenib and placebo for Val600 BRAF-mutant melanoma: a multicentre, double-blind, phase 3 randomised controlled trial","volume":"386","author":"Long","year":"2015","journal-title":"Lancet"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1412690","article-title":"Improved overall survival in melanoma with combined dabrafenib and trametinib","volume":"372","author":"Robert","year":"2015","journal-title":"N Engl J Med"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1904059","article-title":"Five-year outcomes with dabrafenib plus trametinib in metastatic melanoma","volume":"381","author":"Robert","year":"2019","journal-title":"N Engl J Med"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1200\/jco.21.02229","article-title":"Long-term outcomes with nivolumab plus ipilimumab or nivolumab alone versus ipilimumab in patients with advanced melanoma","volume":"40","author":"Wolchok","year":"2022","journal-title":"J Clin Oncol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/j.ejcsup.2013.07.012","article-title":"Melanoma epidemiology, biology and prognosis","volume":"11","author":"Ali","year":"2013","journal-title":"EJC Suppl"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/bf02574484","article-title":"Results after pancreatic resection for metastatic lesions","volume":"9","author":"Hiotis","year":"2002","journal-title":"Ann Surg Oncol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1007\/s12029-010-9169-5","article-title":"Pancreatic resection for metastatic melanoma. Case report and review of the literature","volume":"42","author":"Sperti","year":"2011","journal-title":"J Gastrointest Cancer"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1038\/nrc.2016.37","article-title":"From melanocytes to melanomas","volume":"16","author":"Shain","year":"2016","journal-title":"Nat Rev Cancer"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.rpor.2015.12.001","article-title":"Current treatment options of brain metastases and outcomes in patients with Malignant melanoma","volume":"21","author":"Nowak-Sadzikowska","year":"2016","journal-title":"Rep Pract Oncol Radiother"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2004.05.001","article-title":"The treatment of brain metastases in melanoma patients","volume":"30","author":"Bafaloukos","year":"2004","journal-title":"Cancer Treat Rev"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1007\/s11912-007-0056-6","article-title":"Management of metastatic melanoma patients with brain metastases","volume":"9","author":"Majer","year":"2007","journal-title":"Curr Oncol Rep"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.25634","article-title":"Prognostic factors for survival in melanoma patients with brain metastases","volume":"117","author":"Davies","year":"2011","journal-title":"Cancer"},{"key":"B22","article-title":"Pancreatic resection for metastatic melanoma originating from the nasal cavity: a case report and literature review","volume":"33","author":"Sugimoto","year":"2013","journal-title":"Anticancer Res"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1007\/s10434-001-0658-4","article-title":"Does complete resection of melanoma metastatic to solid intra-abdominal organs improve survival","volume":"8","author":"Wood","year":"2001","journal-title":"Ann Surg Oncol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.0459","article-title":"Association of surgical treatment, systemic therapy, and survival in patients with abdominal visceral melanoma metastases, 1965-2014: Relevance of surgical cure in the era of modern systemic therapy","volume":"152","author":"Deutsch","year":"2017","journal-title":"JAMA Surg"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(09)70065-8","article-title":"The role of surgery in the management of isolated metastases to the pancreas","volume":"10","author":"Reddy","year":"2009","journal-title":"Lancet Oncol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.14740\/wjon1567","article-title":"Cutaneous Malignant melanoma presenting as an isolated splenic metastasis: An update","volume":"14","author":"Alshehri","year":"2023","journal-title":"World J Oncol"},{"key":"B27","first-page":"498","article-title":"Radiological diagnosis of splenic metastasis and its prevalence at autopsy","volume":"51","author":"Imada","year":"1991","journal-title":"Nihon Igaku Hoshasen Gakkai Zasshi"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1186\/1752-1947-5-56","article-title":"Solitary splenic metastasis from ovarian carcinosarcoma: a case report","volume":"5","author":"Olsen","year":"2011","journal-title":"J Med Case Rep"},{"key":"B29","article-title":"Isolated splenic metastasis revealing colon cancer","volume":"81","author":"Rezgui","year":"2003","journal-title":"Tunis Med"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00004110","article-title":"Isolated splenic metastasis from lung cancer: ringleader of continuous fever","volume":"19","author":"Tang","year":"2010","journal-title":"Eur Respir Rev"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.5858\/2007-131-965-smcpdd","article-title":"Splenic metastases: clinicopathologic presentation, differential diagnosis, and pathogenesis","volume":"131","author":"Comp\u00e9rat","year":"2007","journal-title":"Arch Pathol Lab Med"},{"key":"B32","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1016\/s1072-7515(03)00381-8","article-title":"Surgical treatment of splenic metastases in patients with melanoma","volume":"197","author":"de Wilt","year":"2003","journal-title":"J Am Coll Surg"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2024.05.006","article-title":"Targeted therapy innovations for melanoma","volume":"38","author":"Amarillo","year":"2024","journal-title":"Hematol Oncol Clin North Am"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1007\/s11912-023-01402-8","article-title":"Sequencing targeted and immune therapy in BRAF-mutant melanoma: Lessons learned","volume":"25","author":"Trojaniello","year":"2023","journal-title":"Curr Oncol Rep"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.26724","article-title":"NRAS mutation status is an independent prognostic factor in metastatic melanoma","volume":"118","author":"Jakob","year":"2012","journal-title":"Cancer"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2010.32.4327","article-title":"Prognostic and clinicopathologic associations of oncogenic BRAF in metastatic melanoma","volume":"29","author":"Long","year":"2011","journal-title":"J Clin Oncol"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1186\/1479-5876-8-67","article-title":"Incidence of the V600K mutation among melanoma patients with BRAF mutations, and potential therapeutic response to the specific BRAF inhibitor PLX4032","volume":"8","author":"Rubinstein","year":"2010","journal-title":"J Transl Med"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(18)30497-2","article-title":"Overall survival in patients with BRAF-mutant melanoma receiving encorafenib plus binimetinib versus vemurafenib or encorafenib (COLUMBUS): a multicentre, open-label, randomised, phase 3 trial","volume":"19","author":"Dummer","year":"2018","journal-title":"Lancet Oncol"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(20)30934-x","article-title":"Atezolizumab, vemurafenib, and cobimetinib as first-line treatment for unresectable advanced BRAF(V600) mutation-positive melanoma (IMspire150): primary analysis of the randomised, double-blind, placebo-controlled, phase 3 trial","volume":"395","author":"Gutzmer","year":"2020","journal-title":"Lancet"},{"key":"B40","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1007\/s11912-021-01134-7","article-title":"Combined BRAF-targeted therapy with immunotherapy in BRAF-mutated advanced melanoma patients","volume":"23","author":"Ferrucci","year":"2021","journal-title":"Curr Oncol Rep"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1186\/1479-5876-10-107","article-title":"Sequencing of BRAF inhibitors and ipilimumab in patients with metastatic melanoma: a possible algorithm for clinical use","volume":"10","author":"Ascierto","year":"2012","journal-title":"J Transl Med"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.3109\/07357907.2014.885984","article-title":"Sequential treatment with ipilimumab and BRAF inhibitors in patients with metastatic melanoma: data from the Italian cohort of the ipilimumab expanded access program","volume":"32","author":"Ascierto","year":"2014","journal-title":"Cancer Invest"},{"key":"B43","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1016\/j.cell.2017.01.010","article-title":"Genomic and transcriptomic features of response to anti-PD-1 therapy in metastatic melanoma","volume":"168","author":"Hugo","year":"2017","journal-title":"Cell"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1016\/j.soc.2019.02.001","article-title":"Current immunotherapy practices in melanoma","volume":"28","author":"Rothermel","year":"2019","journal-title":"Surg Oncol Clin N Am"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1200\/jco.1999.17.7.2105","article-title":"High-dose recombinant interleukin 2 therapy for patients with metastatic melanoma: analysis of 270 patients treated between 1985 and 1993","volume":"17","author":"Atkins","year":"1999","journal-title":"J Clin Oncol"},{"key":"B46","article-title":"High-dose recombinant interleukin-2 therapy in patients with metastatic melanoma: long-term survival update","author":"Atkins","year":"2000","journal-title":"Cancer J Sci Am"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.ccr-11-1595","article-title":"Ipilimumab: an anti-CTLA-4 antibody for metastatic melanoma","volume":"17","author":"Lipson","year":"2011","journal-title":"Clin Cancer Res"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2014.56.2736","article-title":"Pooled analysis of long-term survival data from phase II and phase III trials of ipilimumab in unresectable or metastatic melanoma","volume":"33","author":"SChadendorf","year":"2015","journal-title":"J Clin Oncol"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(17)31601-x","article-title":"Pembrolizumab versus ipilimumab for advanced melanoma: final overall survival results of a multicentre, randomised, open-label phase 3 study (KEYNOTE-006)","volume":"390","author":"Schachter","year":"2017","journal-title":"Lancet"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1503093","article-title":"Pembrolizumab versus ipilimumab in advanced melanoma","volume":"372","author":"Robert","year":"2015","journal-title":"N Engl J Med"},{"key":"B51","doi-asserted-by":"publisher","first-page":"1270","DOI":"10.1056\/NEJMc1509660","article-title":"Combined nivolumab and ipilimumab or monotherapy in untreated melanoma","volume":"373","author":"Valsecchi","year":"2015","journal-title":"N Engl J Med"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1709684","article-title":"Overall survival with combined nivolumab and ipilimumab in advanced melanoma","volume":"377","author":"Wolchok","year":"2017","journal-title":"N Engl J Med"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2015.64.0391","article-title":"Evaluation of immune-related response criteria and RECIST v1.1 in patients with advanced melanoma treated with pembrolizumab","volume":"34","author":"Hodi","year":"2016","journal-title":"J Clin Oncol"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2018.10.167","article-title":"Pseudoprogression in previously treated patients with non-small cell lung cancer who received nivolumab monotherapy","volume":"14","author":"Fujimoto","year":"2019","journal-title":"J Thorac Oncol"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1736458\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T04:29:08Z","timestamp":1781065748000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1736458\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,10]]},"references-count":54,"alternative-id":["10.3389\/fonc.2026.1736458"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1736458","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,10]]},"article-number":"1736458"}}