case_images: PMC7079252_01
case_images: HE and IHC of histopathology. Histopathology of biopsy of the breast. (a) and (b) show HE staining. Poorly differentiated malignant cells invading stromal areas. (c) shows an IHC positive for AE1/3, which rules out sarcoma. (d)-(f) show negative IHCs for GATA3, SOX100, and S100. These results exclude malignant melanoma.
case_images: CRIONM2020-2518383.001.jpg
case_images: PMC7079252_01_CRIONM2020-2518383.001.jpg
case_images: fig1
case_images: Histopathological examination showed a poorly differentiated carcinoma negative for ER, PgR, HER2, gross cystic disease fluid protein, and GATA-binding protein 3 (GATA3) (Figures 1(a)-1(c)). We excluded a diagnosis of malignant melanoma based on the following IHC findings: positive for pankeratin AE1/3 (Figure 1(d)) and negative for CK8, SOX10 (Figure 1(e)), S100 (Figure 1(f)), melan A, CD45, and desmin.
case_images: (a) CXR before dabrafenib and trametinib initiation. (b) 1 week after treatment. Arrow shows pleural effusion.
case_images: CRIONM2020-2518383.002.jpg
case_images: PMC7079252_01_CRIONM2020-2518383.002.jpg
case_images: fig2
case_images: Adverse Event ver. xx), which we controlled by withdrawing drug administration for a day. The swelling and pain in the right breast improved remarkably after the initiation of dabrafenib and trametinib. A chest X-ray at the 1-week follow-up showed the right pleural effusion had decreased in size (Figure 2(a)).
case_images: (a) Breast sections of CT scan before initiation of dabrafenib and trametinib. (b) Same section 2 weeks after treatment initiation. The arrow points to reduced mass and decreased pleural effusion.
case_images: CRIONM2020-2518383.003.jpg
case_images: PMC7079252_01_CRIONM2020-2518383.003.jpg
case_images: fig3
case_images: There was a general improvement in conditions, and we discharged the patient (Figure 3).
case_images: (a) CT scan section showing right axillary lymph nodes before treatment. (b) CT scan section showing right axillary lymph nodes 6 weeks after treatment initiation. Arrow shows right axillary lymph nodes being decreased after treatment.
case_images: CRIONM2020-2518383.004.jpg
case_images: PMC7079252_01_CRIONM2020-2518383.004.jpg
case_images: fig4
case_images: After 6 weeks of treatment, a CT scan showed further reduction in the size of the tumors in the right breast, axillary lymph nodes, and pleura (Figure 4).