Primary pineal melanoma with long-term survival: Case report

The diagnostic dilemma of primary central nervous system melanoma

“…A systematic search of the indexed medical literature identified numerous case reports and small case series of primary CNS melanoma in diverse locations such as the CP angle, pineal gland, perisylvian cortex, medullar oblongata, cervical spinal cord, ventricles, and sella turcica. [4][5][6][7][8][9][10] We discuss some key issues in the diagnosis, treatment, and clinical course of primary CNS melanomas.…”

Primary Extracutaneous Malignant Melanoma: A Comprehensive Review with Emphasis on Treatment

“…Palliative surgery such as inserting a shunt reduces the pressure in the brain and relieves the patient at least temporarily [70,71,74]. The prognosis of patients with solitary primary intracranial melanomas is reported to be slightly better (mean survival 20.7 months as compared to 6.7 months in patients with diffuse meningeal melanomas) [75]. Beside more general symptoms such as headache, these predominantly adult patients present with various symptoms depending on the localization of the tumor.…”

Primary Pineal Malignant Melanoma

“…This agrees with the small preponderance of primary pineal malignant melanomas with documented MRIs. Three of the four cases, including our own, showed a hyperintense T 1 mass and hypointense T 2 mass [4, 13, 14]. Some previous reports of intracranial melanomas have described a similar MRI pattern of hyper- to isointense T 1 -weighted sequences and variable T 2 -weighted sequences [15, 16].…”

“…The best long-term predictors of survival, though, appear to be the degree of differentiation of the tumor and the presence or absence of leptomeningeal involvement. Only 1 documented case of primary pineal melanoma has reported isolated pineal involvement, and in that report the patient was still without signs of tumor recurrence, post-surgical resection, after 4 years of follow-up [14]. Another report by Suzuki et al [13] documented patient survival up to 1.7 years after the onset of symptoms.…”

“…Foci of hemorrhage and necrosis are also very common in these tumors. Leptomeningeal, ventricular and intraparenchymal invasion are frequently seen in association with primary pineal gland malignant melanoma and seem to represent higher grade lesions [3, 4, 6,9,10,11,12,13,14, 26, 27]. …”