Melanoma maligno primario del sistema nervioso central: un reto diagnóstico

Quillo-Olvera, Javier; Uribe-Olalde, Juan Salvador; Alcántara-Gómez, L. Alberto; Rejón-Pérez, Jorge Dax; Palomera-Gómez, Héctor Guillermo

doi:10.1016/j.circir.2015.04.008

Cited by 5 publications

(14 citation statements)

References 24 publications

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“…Nevertheless, the prognosis of primary CNS melanoma appear to be better than metastatic brain examples, particularly if localized and if complete resection is possible. In these cases, the median survival is 20.7 months [12]. In our case, despite we did not know the nature of the lesion before surgery, we made a complete resection of the lesion as it is shown in control image test (Fig.…”

Section: Discussionmentioning

confidence: 89%

“…The main location of melanocytes is in the piamatter around inferior surface of the cerebellum, spinal medulla, and high cervical medulla. According to Quillo-Olvera et al, the most common locations of primary brain melanoma are the lobe (53.1 %), posterior fossa (17.3 %), and pineal region (13.6 %) [12]. Vijayalaxmi et al did a search between 1989 and 2014, and they found 19 cases of primary CNS melanoma, none of them at the insular region [11].…”

Section: Discussionmentioning

confidence: 99%

“…The same radiological and histological findings make the real diagnosis extremely difficult [12]. Clinically, they presented equal.…”

Section: Discussionmentioning

confidence: 99%

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Primary cerebral malignant melanoma in insular region with extracranial metastasis: case report and review literature

et al. 2016

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BackgroundPrimary brain melanomas are very infrequent and metastasis outside central nervous system very uncommon. There are some cases in the literature about primary melanoma in the temporal lobe; nevertheless, the insular location has never been described.Case presentationThe patient presented as left insular intraparenchymal hematoma with multiple bleedings. Complementary tests did not show any tumoral nor vascular pattern in relation with these bleedings. A complete surgical resection was performed, and the diagnosis of malignant melanoma, with BRAF mutation, was obtained after histology exam. Extension studies were negative for skin or mucous melanoma. 18F-FDG PET/CT was performed and a metastatic lymph node was found. The diagnosis was primary brain melanoma with extracerebral metastasis. Dabrafenib 150 mg/12 h was the only chemotherapy during 5 months. After that, Trametinib 2 mg/24 h was added to the treatment. Eighteen months after surgery, the patient is independent, with stable situation, and without new metastasis.ConclusionsAlthough malignant melanomas have poor prognosis, total surgical resection and new therapies are increasing the overall survival and improving quality of life. In a patient with suspected brain melanoma, in spite of having extracerebral metastasis, aggressive treatment may be considered.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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Primary cerebral malignant melanoma in insular region with extracranial metastasis: case report and review literature

et al. 2016

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“…[2345] It is often described in association with cutaneous melanosis. [16] In the central nervous system (CNS), melanoma is often described in relation to leptomeninges termed as leptomeningeal melanosis. [7] The imaging or histopathological features with recent advances in the immunohistochemical markers do not contribute to distinguish primary from metastatic melanomas that made these patients to undergo thorough investigation.…”

Section: Introductionmentioning

confidence: 99%

“…[7] The imaging or histopathological features with recent advances in the immunohistochemical markers do not contribute to distinguish primary from metastatic melanomas that made these patients to undergo thorough investigation. [26] The lack of guidelines regarding adjuvant treatment in dealing with these tumors results in poor outcome with inevitable recurrences despite complete surgical excision. [3]…”

Section: Introductionmentioning

confidence: 99%

Aggressive primary pediatric intracranial malignant melanoma: Sphinx of the tissue diagnosis

et al. 2019

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It is often intriguing to suspect and confirm the diagnosis of primary malignant melanoma (PMM) in the brain without any evidence of neurocutaneous melanosis. We report a 16-year-old male patient with malignant melanoma which intraoperatively was small sized, soft, fleshy, hemorrhagic in appearance resembling hematoma. Interestingly, the histopathology showed prominent papillary architecture with a differential diagnosis of papillary meningioma and ependymoma and perplexed the tissue diagnosis. This case is discussed in light of very uncommon occurrence of intracranial PMM in pediatric age group, enigmatic histological features, and aggressive nature of lesion with rapid progression despite complete excision following radiation therapy.

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Melanocytic lesions of the central nervous system: a case series

Varela-Poblete

Vidal-Tellez

Cruz

et al. 2022

Arq. Neuro-Psiquiatr.

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Background: Melanocytic lesions of the central nervous system (CNS) are an infrequent, broad and diverse group of entities, both benign and malignant, found in all age groups, with imaging findings ranging from well-circumscribed focal lesions to diffuse leptomeningeal involvement. On MRI, they are usually distinguished by a high signal on T1WI sequences, given the paramagnetic effect of melanin, thus making it difficult to differentiate among them. Objective: To describe the imaging and epidemiological characteristics of a retrospective series of CNS melanocytic lesions. Methods: MR images of 23 patients with CNS melanocytic lesions diagnosed between January 2012 and June 2018 were analyzed. Results: Most patients were female (14/23; 61%), with a median age of 47 years (range: 3 weeks to 72 years). The primary melanocytic lesions accounted for 8/19 cases (42.1%), which included neurocutaneous melanosis, meningeal melanocytomas and primary malignant melanomas. Secondary melanocytic lesions (metastatic) accounted for 10/19 cases (52.6%). There was one case of a tumor with secondary melanization, from a melanocytic neuroectodermal tumor of infancy. There were also four cases of primary ocular melanomas. The most frequent findings were the cerebral location, high T1WI signal and marked contrast-enhancement. Conclusions: The present review describes the wide variety of melanocytic lesions that could affect the CNS, emphasizing the MRI characteristics. Knowledge of the imaging, clinical and epidemiological characteristics of CNS melanocytic lesions is essential for their correct interpretation, given the significant overlap between lesion features and the variable prognosis.

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Melanoma maligno primario del sistema nervioso central: un reto diagnóstico

Cited by 5 publications

References 24 publications

Primary cerebral malignant melanoma in insular region with extracranial metastasis: case report and review literature

Primary cerebral malignant melanoma in insular region with extracranial metastasis: case report and review literature

Aggressive primary pediatric intracranial malignant melanoma: Sphinx of the tissue diagnosis

Melanocytic lesions of the central nervous system: a case series

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