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3311524280012152101
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slova:674460001244370127178230255
metastazující9454600012182132164212250283330373427450472515538
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melanom,18384600012182131155201255309391411
imunoterapie,22664600012123105158212266298346378425481504553572
ipilimumab,2855460001212378101123145227281362409465483
nivolumab,3355460001215577124177200254335382438457
dakarbazin,3404740012156104151200233290339382405461481
temozolomid,842474001213483166222263318342397481504561581
mozkové14454740012183138180227281328377
metastázy.18434740012183134168216255289338381431448
Patient3405040012458110147175228288324
with6855040012475103140200
primary905504001246099126212266304359
metastasizing12845040012486140177231275312366409437485513572631
anorectal19355040012453112170208261307346400428
mucosal23835040012486144190247291345372
melanoma27765040012486139167221280338424477
The3405210012150108159
presented530521001215791142183235291325376434
case995521001214594135186
report1212521001213384142199233271
describes15135210012157108149195229254312364405
the1948521001213390142
case2120521001214595135187
of2337521001215686
a24535210012149
patient25325210012157107141165217274307
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mucosal30895210012184140186241282332357
primary3476521001215791116201250284335
metastasizing3405350012184137172223263299349390415459484541599
malignant9705350012185134159184242299349406440
melanoma14415350012184137162212269326412462
of1934535001215586
the2051535001213390143
anorectum.22255350012148106163197249296333390475498
Due27545350012167125177
to2962535001213490
the3082535001213491143
synchronous3256535001214090148195252286343400457514555
generalization3405490012156108166218252302327352396447481506562620
to991549001213389
the1110549001213491143
lymph1283549001212473159218275
nodes15895490012156113172224265
and18855490012148105164
lungs2079549001212481138195236
and23455490012149106164
therefore2540549001213390142177228259316350402
the2973549001213390142
impossibility31465490012123108167224265306330388413438463497549
of3725549001215686
a3405630012148
curative4195630012144100134184217241291341
surgical790563001214096129186210256306330
or1151563001215589
radiotherapy1270563001213382140164221254311362396446504551
solution,1852563001213996121177211235291348370
the2252563001213389141
patient24235630012157107141165216273306
was27605630012173123163
treated2953563001213467118167201251310
with3293563001217498133189
several3512563001214091140190224274299
lines340577001212448104155196
of556577001215585
systemic662577001213988129164214299323369
treatment.1051577001213367118167200284336393426448
In1520577001212480
accordance1620577001214994139194228285334390436486
with2127577001217398132188
guidelines23365770012155111135193244269293349401441
and27985770012148104162
for2981577001212985119
BRAF31205770012154109174223
negativity,33635770012156107165214248272321346380431448
combined3405910012145100184242267323375433
immunotherapy8035910012124108192248304361394451502536586643691
with1524591001217498133189
ipilimumab1743591001212381106130154238294378428486
and22595910012148104162
nivolumab2451591001215680129184209265349398456
was29385910012173123163
indicated3131591001212380137162207257290341399
in3560591001212480
the3670591001213390141
1st340605001215185120
line480605001212347103154
of654605001215585
treatment.758605001213367117166199283335391424446
Subsequently,12246050012149104162202253311367418474507531579596
due18406050012156112163
to2022605001213388
repeated2130605001213383141193242275325383
progression2533605001215690145203236287327367391446503
of3055605001215585
the3160605001213389140
disease,3320605001215680119171219259310331
the3671605001213389140
patient3406190012157106139163213269302
completed662619001214498182240264315349399457
two11386190012133109164
more13216190012183139172223
lines1563619001212447103154194
of1776619001215585
conventional1880619001214599155202251307340364420476524548
chemotherapy24486190012144100151234290324379430464513570617
and30846190012148104161
then,3264619001213389140196217
regarding3501619001213282140188221278340633001212380137
metastatic5016330012183135169219259294344378402447
spread973633001213997131181230288
to1285633001213388
the1398633001213389140
brain,1563633001215791140164221242
three1830633001213389122173225
more20796330012184140174225
cycles2328633001214595140164216256
of2608633001215585
temozolomide2718633001213383168224267322347403488512570621
treatment.3363633001213467118167200285336393426448
Brain340647001215488137161217
metastases5776470012183135169219259294343383435475
were10726470012173124158208
treated1300647001213367117166200250308
with1628647001217398132188
the1836647001213389140
Leksell1996647001214798146189240265289
Gamma23056470012165114198282331
Knife26566470012154112136166217
(LGN),2893647001212976138205234253
later3166647001212473106156190
for3376647001212985119
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progression340661001215791146204238288329369393449506
the874661001213389140
palliative10426610012157107131156180228262286335385
whole14556610012174131187212263
brain1746661001215791141165221
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(WBRT)25736610012128116171226278310
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At3357661001216193
the3478661001213390141
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her4506750012156107141
life,61767500121234778129150
the792675001213390141
patient9586750012157107141165216273306
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palliative17876750012157107131155179228262286335385
radiotherapy2197675001213383140164220254310362396445503550
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lesion340689001212475115138194250
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the817689001213389140
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the1643689001213389140
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later2725703001212372106156190
a29387030012148
home30097030012155111196247
hospice.32797030012156112152209234280330351
The36537030012149107158
patient3407170012157107140164215272305
died665717001215680131190
338757170012151100
months9957170012184140197230286326
after1341717001214878115165199
the1560717001213389140
diagnosis1720717001215781130187243299339363403
of2143717001215484
metastatic22477170012184135170219259294344377401447
melanoma27147170012183135160209265321405454
and31887170012149105162
123370717001215297
months34877170012183139196229285325
after340731001214878116166200
the563731001213389141
diagnosis727731001215680129186243299339363403
of1153731001215585
brain1261731001215791140164221
metastases.15057310012183135169219259294344384435476498
Key3407490012461112163
words:5207490012475132170230273299
metastatic8367490012183133166215253287335367390434
mucosal12887490012183137182235274323346
melanoma,16517490012183133157204259314397445465
immunotherapy,21347490012123106188243298352385439489522570626672688
ipilimumab,2840749001212379102125148231285368415472491
nivolumab,3348749001215678126180203258340388444464
dacarbazine,3407630012156104149198230287336379403458509528
temozolomide,890763001213382166221263317341396480503560610630
brain1541763001215790139162217
metastases.17797630012184134168216256289338377428467489
DECLARATIONS:4068249008648871301662142563043393604124625014570249008514
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originality:45372630087406888130150192230251271298337356
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Recommendations406840900853977112153216278317359402439465483525568598
for46974090085226389
the481840900852466104
Conduct,495440900854283125168210245272290
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Editing,40684200085347491115132172212227
and430842000853373113
Publication443442000853776117134151183218242259298338
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Scholarly485742000853467106146163198221239273
Work514242000856097121155
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Medical537842000855693134151183218235
Journals,406843100852666105129169204221249265
updated435343100853980121155179215256
in462943100851656
December470543100854683116151211252289313
2018,503743100853673107140156
including52134310085165689106145186203243283
patient55164310085407540684420085234076116140
consent422244200853270110138174214238
where447544200855191127151187
appropriate.467744200853474115139178219243260295318354369
Conflict406845500874282124149171191223251
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interest44134550087196288126154192224251
and467845500873779122
financial48144550087244587125167200220258279
disclosures:51074550087416293126147188220261289327359378
None.406846600854686126162177
Funding/Support:406848000873777119162183225267291329371414457499526554574
None.406849100854686126162177
Cit.4068703008541588297
zkr:41807030085306489105
Onkologie.429970300864991127167186227268287324342
2025;19(2):100-103465570300863876113151167203238260297317334370405445470504539577
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Článek40687250085415892132168202
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MUDr.4068755008759108158186202
Linda42847550087365698141179
Řandová447775500874280122165206244282
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