Сlinical case of treatment of metastatic melanoma

a tumor of the skin of the back with a reconstructive plastic component.  
Pathology histological test No. 134569-74 of August 31, 2015 showed the nodular pigment melanoma from spindle-shaped and nevus-like cells without ulceration, 2 mm height Breslow, Clark invasion II level, against previous nevus, mitosis is 1 per mm2, severe lymphoid infiltration.
There is no tumor growth along the cut-off lines. Dynamic observation is recommended.

the axillary lymph node on the right and on the left.
Surgery: axillary-subscapular lymphadenectomy on the right.  
Axillary lymphadenectomy on the left. BRAF mutation was detected.  
There was radiation therapy on the right and left axillary regions. The immunotherapy with Interferon alpha 3-5 million IU is recommended. 
Patient J. received immunotherapy for 1 year.

lymph node on the right.
August 4, 2017 there was a surgery: right-side posterior-lateral cervical lymphatic dissection.
Immunotherapy with dose escalation up to 9 million IU is recommended.

the mediastinum and perinephric fat were found.
 There were formation of an unclear etiology in the thyroid gland. No lesions of the brain substance were detected. Treatment with BRAF + MEK inhibitors is recommended. Since September 2017, she has been taking Dabrafenib in combination with Trametinib.
PET-CT was on November,29 2017. The information of active specific tissue at that moment of the study were not received. There are postoperative fibrotic changes in the axillary region from both sides.
Therapy with Dabrafenib and Trametinib is continuing.