Malignant Melanoma with Concurrent BRAF E586K and NRAS Q81K Mutations
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Updated: Apr 28, 2026

Spatial and Temporal Control of Murine Melanoma Initiation from Mutant Melanocyte Stem Cells
Published on: June 7, 2019
Rodney Shackelford1, Maressa Pollen1, Moise Vora1
1Department of PathologyClinical Pathology Molecular Pathology Consultative Services, La., USA.
Abstract:
Cutaneous melanoma is an aggressive malignant tumor of melanocytes which accounts for 80% of skin cancer-related deaths. A number of driver mutations have been identified in melanoma, with the mutually exclusive BRAF V600E and NRAS Q61A mutations together accounting for roughly 70% of mutations. Simultaneous BRAF V600E and NRAS Q61A mutations in melanoma are rare, with evidence suggesting that up to 2.9% (2/69) of primary cutaneous melanomas carry both mutations. Here we describe a 42-year-old man with concurrent BRAF E586K and NRAS Q81K driver mutations. To our knowledge, this is the first description of these driver mutations occurring simultaneously in primary cutaneous melanoma.
Insights
This study reports the rare simultaneous occurrence of BRAF E586K and NRAS Q81K mutations in a patient with primary cutaneous melanoma, a finding not previously documented in scientific literature.
Area of Science:
- Oncology
- Genetics
- Dermatology
Background:
- Cutaneous melanoma is an aggressive skin cancer originating from melanocytes, responsible for a significant proportion of skin cancer deaths.
- BRAF and NRAS mutations are common drivers in melanoma, typically occurring exclusively of each other.
- The concurrent BRAF V600E and NRAS Q61A mutations are documented in a small percentage of primary cutaneous melanomas.
Observation:
- A case study of a 42-year-old male patient with primary cutaneous melanoma is presented.
- This patient exhibited concurrent driver mutations: BRAF E586K and NRAS Q81K.
- These specific mutations (BRAF E586K and NRAS Q81K) have not been previously reported together in primary cutaneous melanoma.
Findings:
- The simultaneous presence of BRAF E586K and NRAS Q81K mutations in primary cutaneous melanoma is described for the first time.
- This case expands the known spectrum of co-occurring driver mutations in melanoma.
Implications:
- Understanding rare mutation combinations like BRAF E586K and NRAS Q81K is crucial for advancing melanoma research.
- This finding may inform future diagnostic and therapeutic strategies for cutaneous melanoma.
- Further investigation into the clinical significance and biological impact of these concurrent mutations is warranted.
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