Primary Intracranial Melanoma Research Articles

Neurocutaneous melanosis presented with giant congenital melanocytic nevi and primary intracranial melanoma

Neurocutaneous melanosis is a rare neurocutaneous syndrome defi ned by the presence of multiple and /or giant congenital cutaneous nevi and melanocytic deposits in the central nervous system with the infi ltration of leptomeninges. The major medical concern with giant congenital cutaneous nevi is high risk of developing cutaneous melanoma, leptomeningeal melanoma, and neurocutaneous melanosis. Neurological symptoms usually develop before 2 years of age, but rare in the second or third decades of life. A 24-year-old-man with giant hairy, pigmented nevus on his extremities, back, “bathing trunk” variety presented with onset of neurological symptoms only in second decade of life. Magnetic resonance imaging of brain revealed a large expansive lesion in the left parieto-occipital lobe with high intensity on T1- sequence, and was heterogeneous on T2-sequence with iso- and hyper intense areas. Post-surgical pathological diagnosis revealed characteristics of malignant melanoma. Our patient represents a rare association between neurocutaneous melanosis with giant congenital cutaneous nevi and development of primary intracranial melanoma with neurological symptoms appearing in adult life. The onset of neurological symptoms only in third decade of life in our patient illustrates the importance of recognizing the likelihood of neurocutaneous melanosis in children with giant congenital nevus with or without neurological symptoms.Journal of Kathmandu Medical College, Vol. 4(1) 2015, 29-33

Primary intracranial malignant melanoma in an adolescent girl: A case report

Primary intracranial malignant melanoma is a very rare tumor, and most of the central nervous system melanomas are metastatic diseases. Diagnosis needs extensive dermatological, opthalmological, and radiological workup to exclude metastatic melanoma. Histologically, it should be differentiate from benign melanocytic lesions, pigmented choroid plexus carcinoma, and pigmented papillary medulloblastoma. Here, we are reporting a case of primary malignant melanoma of posterior fossa in an adolescent girl diagnosed in squash cytology as well as in histology and confirmed by immunohistochemistry and by excluding metastatic melanoma.

Primary Intracranial Melanoma with Early Leptomeningeal Spread: A Case Report and Treatment Options Available.

Primary CNS melanomas are rare and they constitute about 1% of all cases of melanomas and 0.07% of all brain tumors. These tumors are aggressive in nature and may metastasise to other organs. Till date less than 25 cases have been reported in the literature. The primary treatment for local intraparenchymal tumours is complete resection and/or radiotherapy and it is associated with good survival. However once there is disease spread to leptomeninges the overall median survival is around 10 weeks. In this case report we describe a primary intracranial melanoma without any dural attachment in 16-year-old boy who had radical excision of the tumor followed by radiotherapy who eventually had rapidly developed leptomeningeal disease and review the literature with a focus on the clinic pathological, radiological, and treatment options.

English

Primary intracranial melanoma is a rare and uncommon lesion. Association of primary CNS melanoma in an albino has not been reported in literature searched till now. We are presenting a rare case of primary CNS melanoma in a 52years old male with occulocutaneous albinism. The patient presented with repeated episodes of generalized headache, vomiting and ataxia for duration of 5months. MRI examination showed a tumor in the posterior fossa that was diagnosed as Ependymoma radiologically. Surgical treatment with total removal of tumor was done. Intra- operative squash cytology and frozen section followed by histopathology confirmed the diagnosis of Melanoma. A thorough investigation of the patient was performed including chest radiography, ocular examination, ultrasonography of abdomen and barium enema to rule out any other site of primary melanoma in the body. Thus a final diagnosis of primary CNS melanoma was given.

Microsurgery for the treatment of primary malignant intracranial melanoma: A surgical series and literature review

Primary malignant intracranial melanomas are rare tumors of the central nervous system. These tumors are highly malignant and are associated with poor prognosis. The field of neurosurgery has struggled with the diagnosis and treatment of these tumors. In this study, we present a surgical series of eight patients with primary malignant intracranial melanomas and retrospectively analyze the clinical features, imaging findings, pathological features and prognoses of these patients. All patients underwent microsurgery. Total and subtotal resection of the tumor was achieved in six and two patients, respectively. Of the eight patients, seven showed improvement while one remained the same at time of discharge. There was no neurosurgical deterioration. Radiotherapy was conducted in six patients after operation. The average follow-up duration was 13.8 months (range = 9-26 months). During the follow-up period, three patients died from this disease. One patient suffered from recurrence at the 16th month and underwent second surgery. The other patients were still alive with no evidence of tumor recurrence. Microsurgery and radiotherapy should be the first line managements for patients with primary malignant intracranial melanomas. Improvements in chemotherapy, immunotherapy and targeted therapies may provide more effective treatments for malignant intracranial melanomas.

Management preferences and prognosis for primary intracranial melanocytic neoplasms

Background: Contrary to relatively frequent metastatic melanoma, primary melanocytic CNS neoplasms are rare, coming up from melanocytes situated in the leptomeninges. These lesions incorporate diffuse meningeal melanomatosis, melanin-pigmented meningioma, well-differentiated benign melanocytoma, and primary malignant intracranial and/or spinal melanoma.

Microsurgical treatment for malignant intracranial melanomas:2 case reports and review of the literature

Primary malignant intracranial melanomas are rare tumors of the central nervous system, while the secondary or brain metastatic melanomas are among the top three brain metastatic lesions. These tumors are highly malignant and are associated with poor prognosis. The neurosurgeons have struggled with the diagnosis and treatment of these tumors. In this report, we retrospectively analyzed the clinical features, imaging findings, pathological features and prognoses of two patients who were diagnosed as having malignant intracranial melanomas. In addition, we reviewed the literature regarding diagnostic and therapeutic strategies for treating these unusual malignant lesions.

Diagnosis and treatment for primary intracranial melanoma

Objective To investigate the clinical features, imaging findings and treatment for primary intracranial melanoma. Method The clinical data including presentation, imaging, treatment and prognosis of 8 patients with primary intracranial melanoma underwent surgery were reviewed during the past ten years. The patients included six males and two females and the age range was from 24 to 68 years. Four lesions were located in frontal lobe and the other four were located in parietal lobe, Occipital lobe, parafalcine and cerebellopontine angle respectively. Total removal was achieved in 6 patients and subtotal resection in 2 who had adjuvant radiosurgery. Results Histological examination showed that all cases were melanoma. Follow - up study was gained in seven cases and the follow - up duration was from 10 to 82 months. Two patients died from recurrence at postoperative 14th months and 21st months respectively. One case had tumor recurrence 6 months after surgery and another operation was performed to gain total removal. Adjuvant chemotherapy was performed and there was no recurrence found in MRI 6 months after the surgery. One patient had tumor recurrence 9 months after surgery and another operation was performed to gain total removal. Adjuvant chemotherapy was performed and follow - up MRI showed recurrence 6 months after surgery. There was no recurrence in the other 3 cases. Conclusions Primary intracranial melanoma is an extremely rare tumor and difficult to get correct preoperative diagnosis. Surgical removal of tumor plays an important role in its treatment. Part of patients could gain profits from radiotherapy and chemotherapy. The prognosis is very poor. Key words: Melanoma; Central nervous system neoplasms; Diagnosis; Therapy

Primary intracranial melanoma: a case report

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Bilateral Cerebellopontine Angle Metastatic Melanoma: A Case Report

Although melanoma accounts for approximately 1% of all malignancies, melanoma metastases to the cerebellopontine angles (CPAs) are exceedingly rare. Here we describe a patient with melanoma metastases to the internal auditory canals and CPAs who presented with a remote history of cutaneous melanoma. This patient had a rapidly progressive hearing loss, vestibulopathy, and facial nerve dysfunction. Magnetic resonance imaging demonstrated bilateral, enhancing CPA lesions but was otherwise nonspecific. The diagnosis required a careful history, unilateral surgical resection for tissue acquisition, and histopathologic confirmation. A search for primary cutaneous melanoma at the time of presentation was negative. However, the history of cutaneous melanoma 8 years earlier distinguishes this patient's metastatic disease from solitary primary intracranial melanoma, an equally rare disease. Treatment consists of surgical excision, radiation, chemotherapy, and immunotherapy. The prognosis for patients with melanoma metastases is generally poor, but isolated reports of long-term survival have been described. Metastatic disease to the CPAs must be included in the differential diagnosis for any patient presenting with rapid-onset VIIth or VIIIth cranial nerve symptoms.

Primary Malignant Cerebellopontine Angle Melanoma Presenting as a Presumed Meningioma: Case Report and Review of the Literature

Primary intracranial melanomas are rare, especially in the primary cerebellopontine angle. We describe a patient with a presumed jugular foramen meningioma that was found to be of melanotic origin at surgery. We followed this 26-year-old woman with mild ataxia with serial imaging for 18 months after the initial discovery of a cerebellopontine angle extra-axial mass. She developed worsening symptoms of ataxia, dysphagia, and right-sided hearing loss. Magnetic resonance imaging showed an interval increase in size of the mass. The lesion was thought to be a meningioma with a dural tail that extended into the jugular foramen and hypoglossal canal. She underwent preoperative angiography and attempted tumor embolization, followed by resection via a transcochlear infratemporal approach. At surgery the lesion was found to be heavily pigmented. Pathological analysis was consistent with a low-grade melanoma. No primary extracranial site was identified. One year after surgery the patient remains free of systemic disease or recurrence.

Primary Intracranial Melanoma: Report of Case and Review of the Literature

Primary intracranial melanoma is uncommon and accounts for only approximately 1% of all cases of melanoma. This is interesting to neuro-oncologists and neurosurgeons because the clinical and radiological patterns of these tumors can mimic the presence of meningioma. In Spite of their malignant behavior, they can be satisfactorily treated. We describe a 66-year-old woman with traumatic subdural hematoma and an extra-axial tumor mass over the right occipital region. She had no extracranial abnormalities. The patient received total extirpation of the lesion microscopically, followed by radiotherapy. The pathologic review revealed a deep pigmented and hemorrhagic malignant melanoma. It has been demonstrated that surgical excision of intracranial melanoma is the most effective procedure, allowing for a long-term disease-free period postoperatively.

Neurocutaneous Melanosis: A Case of Primary Intracranial Melanoma with Metastasis

Neurocutaneous melanosis is a rare disorder characterized by the presence of large or multiple congenital melanocytic naevi and benign or malignant pigment cell tumours of the leptomeninges. Distant metastasis is unusual in primary leptomeningeal/intracranial melanomas. We present the case history of an adult male who had multiple primary intracranial melanomas associated with neurocutaneous melanosis (naevus of Ota) in the ophthalmic division of the left trigeminal nerve. Excision of the intracranial tumours was carried out in two stages, but the patient died 2 days after the second operation. Autopsy showed multiple metastatic deposits in the liver. Symptoms and signs of raised intracranial pressure, the presence of Ota's naevus, and a dural-based mass or masses should alert the treating physician to suspect a primary leptomeningeal/intracranial melanoma.

Neurocutaneous Melanosis: A Case of Primary Intracranial Melanoma with Metastasis

Neurocutaneous Melanosis: A Case of Primary Intracranial Melanoma with Metastasis

PRIMARY CEREBRAL MALIGNANT MELANOMA: AN UNUSUAL CAUSE OF DYSPRAXIA

SUMMARY Primary intracranial melanomas are rare and occur mainly in young adults. Originating from leptomeningeal melanoblasts and extending into the parenchyma, the tumours closely resemble meningiomas, from which they are radiologically difficult to distinguish despite progress in neuroimaging. Definitive diagnosis is usually made on histopathological examination, though confirmed only after post‐mortem examination in some cases. Prolonged disease‐free periods, and in rare cases long‐term survival, are possible following successful total surgical excision. This case presented with typical clinical features but, at 79 years old, an unusual age.

Primary pineal melanoma with long-term survival: Case report

A rare case of primary pineal melanoma is reported. The patient was a 53-year-old woman who complained of a severe headache. Computed tomography and magnetic resonance images revealed obstructive hydrocephalus caused by a mass lesion in the pineal region. A biopsy was performed through an occipital transtentorial approach. A black pigmented solitary tumor was seen without leptomeningeal dissemination. Histologic examination revealed melanoma. Chemotherapy consisting of dacarbazine, ACNU, vincristine, and interferon was used. Follow-up imaging studies showed dramatic reduction of the tumor without recurrence for 4 years. This report demonstrates that a solitary primary intracranial melanoma without leptomeningeal dissemination and with rare mitoses may yield a good result with chemotherapy.

Primary solitary intracranial melanoma: Case report and review of the literature

Among CNS tumors, intracranial melanomas represent a subject of interest for neurooncologists and neurosurgeons because clinical and radiological patterns of these tumors can mimic the presence of meningiomas, and in spite of their malignant behavior they can be satisfactorily treated. In the present report we describe a new case of primary intracranial melanoma that displayed some radiological features of meningioma; we review the clinical features of 80 previously well-documented cases. The importance of neuroradiological and histochemical (S-100 protein, antimelanin antibodies, proliferating cell nuclear antigen staining) methods and of flow cytometry in helping with histopathological examination is stressed. Review of the clinical histories demonstrates that surgical excision is recommended in most cases, depending on tumor location, and that if total removal is performed, longterm disease-free periods can be attained.

Primary malignant melanoma of the gasserian ganglion associated with neurofibromatosis

A case of primary intracranial malignant melanoma of the left gasserian ganglion associated with temporal lobe gliosis in a patient suffering from von Recklinghausen's disease is reported. The association of primary malignant melanoma of the trigeminal nerve and neurofibromatosis is discussed.

Primary Intracranial Amelanotic Melanoma

Primary intracranial amelanotic melanoma was verified at autopsy in a 38-year-old male. Correct diagnosis of amelanotic melanoma needs electron microscopy or immunohistochemistry, since Masson staining is negative due to the absence of melanin pigment. We adopted the following criteria for clinical use: macroscopically not dark and microscopically negative for Masson staining, but ultrastructurally various melanoma types present. Although the clinical profile of this case is consistent with melanotic melanoma, the more detailed features of primary intracranial amelanotic melanoma require future study.

Primary Intracranial Melanoma

We present a rare case of primary intracranial melanoma in the right occipital region of a 76-year-old male. Magnetic resonance imaging showed an isointensity mass with shorter T1 and T2 relaxation times than those of the opposite hemisphere. A well-defined, dark black tumor was totally removed and histologically diagnosed as malignant melanoma. Eight months postoperatively, however, the tumor recurred and was excised again. He was doing well 1 year after the second operation without additional treatment. In our case, 1) no systemic melanomas were found in close clinical examinations; 2) there was a single nodular tumor attached to the leptomeninges; and 3) a favorable outcome was obtained by surgical treatment alone. These results are consistent with the diagnosis of primary intracranial melanoma.