› Forums › Cutaneous Melanoma Community › Adrenal Node Growing
- This topic has 2 replies, 3 voices, and was last updated 2 years, 10 months ago by
Threefitty.
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- June 17, 2021 at 12:03 pm
Received scan results yesterday and was informed an Adrenal node is growing and needs to be evaluated by the review board.Does anyone have experience with diagnosis and treatment of melanoma that has spread to the Adrenal gland?
Thanks!
History below:
2008 Melanoma in situ Stage 0 (small dark spot lower right leg)
2015 Melanoma Stage 2B (skin tag upper right thigh
Had wide excision surgery. Sentinel node biopsy was negativeNovember 2015
Lab report
“mature melanoma”,Breslow Thickness – 2.85 mm, Clark’s Level: Four, Ulceration: Present
January 31, 2020
CT Scans of Chest, Abdomen, and Pelvis showed 19 mm groin lymph node concerning for metastatic diseaseFebruary 11, 2020
Biopsy – confirmed as MelanomaFebruary 17, 2020
Immunotherapy Round 1 (Opdivo/Yervoy combo)March 2, 2020
Dermatologist removed more superficial melanoma of new lower right leg spotMarch 9, 2020
Immunotherapy Round 2 (Opdivo/Yervoy combo)
April 14, 2020
Received NEO Genomics report – confirmed BRAF+March 30, 2020
Scheduled for Immunotherapy Round 3 (Opdivo/Yervoy combo)
Infusion did not take place
Liver numbers high AST 115, ALT 257
Steroids prescribed (Prednisone 10 mg taper)
April 20, 2020
Immunotherapy (Opdivo only)May 4, 2020
Scheduled for Immunotherapy (Opdivo only)
Infusion did not take place
Liver numbers
AST 217, ALT 482
Steroids prescribed (Prednisone 10 mg taper)May 7, 2020
MRI and CT scans revealed lymph node was smaller – partial response to immunotherapyJune 11 2020
SURGERY
Complete Superficial Inguinal DissectionAugust 10, 2020
Brain MRI, CT Scan of Chest/Abdomen/Pelvis — all goodNovember 16, 2020
CT Scan of Chest/Abdomen/Pelvis — all goodFebruary 16, 2021
CT Scan of Chest/Abdomen/Pelvis , CT Scan Right lower extremity — all goodJun 16, 2021
Brain MRI, CT Scan of Chest/Abdomen/Pelvis , CT Scan Right lower extremityInformed that an ADRENAL NODE is growing and that it needs to be evaluated by the Tumor Review board
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- June 18, 2021 at 8:27 am
<hr />Though I have not had any mets to the adrenal gland personally, I would assume that it would be treated as any other met. With the notation that adrenal function would need to be monitored and supplemental hormone therapy be supplied if needed. (However, with one gland still unaffected that may not pose any problem.) So the real questions to me are ~
- Is this melanoma? Do we need to biopsy?
- If it is melanoma, along with your history of prior immunotherapy and resulting liver issues, what is the treatment option?
- Surgery? Apart from it being one of your adrenals, surgery can still be a good solution. Here are two reports on just that – https://chaoticallypreciselifeloveandmelanoma.blogspot.com/2020/08/surgical-removal-of-lesions.html and https://chaoticallypreciselifeloveandmelanoma.blogspot.com/2019/07/cut-it-out-prolonged-overall-survival.html
- Then again, as even the post points out, we have also learned that treatment with the tumor in place – NEOADJUVANT treatment – can be a good option. Targeted or immunotherapy can be used. Here are a zillion articles: https://chaoticallypreciselifeloveandmelanoma.blogspot.com/search?q=neoadjuvant
- Given your BRAF positive status, perhaps it is time to use that. Pertinent articles: https://chaoticallypreciselifeloveandmelanoma.blogspot.com/search?q=braf
- Targeted therapy is best when both a MEK inhibitor and BRAF inhibitor are used. Strangely, when combined response rates are better and side effects are diminished. Here is the best analysis I could come up with regarding the various combos – https://chaoticallypreciselifeloveandmelanoma.blogspot.com/search?q=Braftovi
- Finally, clinical trials are another option.
So… These are the things that I would want to discuss with my onc if I were in your shoes. I hope this helps and I wish you my best. Celeste
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- June 18, 2021 at 9:10 pm
On treatment after first metastases, i discontinued the combo after 2 doses of the combo due to colitis. i had those 3 tumors disappear (NED) . After massive outbreak 6 months later, including both adrenals, I was given modified combo with yervoy reduction. again this triggered much lighter colitis – manageable but also treatment stopping. However, the result so far has included reduction of adrenal tumor size. i’m now on optivo maintainence.obviously we are all different in situtions related to our immuno-aversity, my experience is a return to the “safe-side” immuno of optivo. I don’t have Braf+ options. That probably would have happened instead if it was an option – given my tumor load being significant when we crossed that bridge. Your tumor load profile will vary.
hopefully you are not dealing with this on review. FWIW, I have not experienced a unusual fatigue or side effects from having my adrenals full of mel. some lowered libido. If you don’t know the why’s/wherefores of the liver and combo relationship, it might be good to know.
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