Primary malignant melanoma of the central nervous system: A diagnostic challenge

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

doi:10.1016/j.circen.2015.08.008

Cited by 7 publications

(13 citation statements)

References 24 publications

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“…Commonly, it is reported in age groups from 35 to 50 years. [2,6,8,9] The most common sites are; lobar (53.1%), posterior fossa (17.3%), and pineal region (13.6%), and with a male dominance. In children most often it is associated with neurocutaneous melanosis or giant congenital nevus.…”

Section: Discussionmentioning

confidence: 99%

“…In children most often it is associated with neurocutaneous melanosis or giant congenital nevus. [1,2,6] PMM in the CNS includes in <3% of all childhood neoplasms. [4,10] The melanocytes of the leptomeninges play a role in the origin of PMM in the CNS.…”

Section: Discussionmentioning

confidence: 99%

“…[5] The somatic mutation in the NRAS oncogene in the melanocytes of the CNS is a risk factor to develop PMM in children. [1,6] It is often difficult to diagnose a primary CNS melanoma outright. Primary CNS melanoma is the diagnosis of exclusion from the more commonly seen metastatic disease in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4][5] It is often described in association with cutaneous melanosis. [1,6] 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. [2,6] The lack of guidelines regarding adjuvant treatment in dealing with these tumors results in poor outcome with inevitable recurrences despite complete surgical excision. [3] Case Report A16-year-old male patient was presented with headache and vomiting for 2 months.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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Primary intracranial malignant melanomas: A case series with literature review

Chen,

Yang,

et al. 2024

Medicine

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Rationale: There is a high chance of misdiagnosis and limited knowledge regarding therapeutic strategies owing to the rarity of primary intracranial malignant melanoma (PIMM). The objective of the present study was to evaluate the clinical features, treatment modalities, and outcomes of patients with histologically proven PIMM. Patient concerns: Data of 15 patients with PIMM admitted to the Chinese People’s Liberation Army General Hospital in a 14-year period between January 2005 and January 2019 were collected. Clinical presentations, pathology, surgical strategies, adjuvant treatment, and prognosis were retrospectively analyzed. Diagnoses: CT showed iso- or high-density lesions in 12 cases (80%). MRI revealed short T1 and slightly short T2 in 14 cases (93.3%).The tumors showed mild or no enhancement on enhanced MRI. The patients were eventually diagnosed with PIMM through pathological examination. Interventions: The treatment modalities included radical resection followed by conventional radiotherapy (RT, n = 12) and subtotal resection followed by stereotactic radiosurgery (n = 3). Outcomes: All 15 patients had either recurrence or metastasis at an average of 14.7 months (range, 6–23 months) after surgery. In total, 14 patients (93.3%) succumbed to disease, with a mean overall survival of 22 months (range, 6–36 months). The median survival time was 23 months. The overall survival rates at 1, 2, and 3 years were 80, 47, and 13%, respectively. Radical resection with RT was associated with longer overall survival (log-rank, P < .05) than subtotal resection followed by stereotactic radiosurgery. Lessons: PIMM is an extremely rare tumor with a poor prognosis. Radical resection with RT may result in a longer overall survival rate. Targeted immunotherapy may be a promising treatment option for PIMM.

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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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Primary malignant melanoma of the central nervous system: A diagnostic challenge

Cited by 7 publications

References 24 publications

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

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

Primary intracranial malignant melanomas: A case series with literature review

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

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