A Case of Pediatric Spitz Melanoma With a ZEB2 :: ALK Fusion

We present a rare case of Spitz melanoma in a 3-year-old male patient with a ZEB2::ALK fusion. This ALK-fused tumor exhibited aggressive behavior, recurring after an initial wide local excision and progressing despite neoadjuvant immunotherapy with a PD-1 inhibitor. Following a second surgical resection and adjuvant radiation therapy, the patient was started on adjuvant targeted therapy with lorlatinib, an ALK kinase inhibitor. This report illustrates the role of immunotherapy and targeted therapy in melanoma treatment.