# Case Report: Anlotinib combined with radiotherapy achieves sustained disease control in advanced malignant melanotic nerve sheath tumor

## TL;DR

A 54-year-old woman with advanced melanotic nerve sheath tumor showed long-term improvement with anlotinib and radiotherapy.

## Contribution

This is the first reported case demonstrating the effectiveness of anlotinib combined with radiotherapy for MMNST.

## Key findings

- The patient achieved over 32 months of progression-free survival with anlotinib and radiotherapy.
- The combination therapy may offer a promising treatment option for advanced MMNST.
- This case provides clinical evidence for managing a rare and aggressive tumor subtype.

## Abstract

Malignant melanotic nerve sheath tumor (MMNST) is a rare and aggressive subtype of malignant peripheral nerve sheath tumor (MPNST) characterized by melanin-producing cells. Due to its rarity, there is currently no standardized therapeutic strategy, posing significant challenges in selecting effective treatment modalities.

We report the first documented case of a 54-year-old female with recurrent MMNST and multiple pulmonary metastases. Following local radiotherapy combined with systemic anlotinib treatment, the patient achieved prolonged progression-free survival (PFS) exceeding 32 months.

This case suggests that anlotinib combined with radiotherapy may be an effective therapeutic option for advanced MMNST, providing valuable clinical evidence for managing this malignancy.