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CC BY-NC-ND 4.0 · Asian J Neurosurg
DOI: 10.1055/s-0044-1788633
Case Report

Metastatic Malignant Melanoma of Brain: A Rare Case Report

Manoj Kumar Seervi
1   Department of Neurosurgery, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
,
Surendra Jain 
1   Department of Neurosurgery, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
,
Ugan Singh Meena
1   Department of Neurosurgery, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
,
Devendra Kumar Purohit 
1   Department of Neurosurgery, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
› Author Affiliations Funding None.
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Abstract

Malignant melanoma is third most common cause of brain metastasis after lung and breast cancer. Most patients with brain metastases from malignant melanoma are diagnosed after treatment for known extracranial metastases and have a poor outcome despite various local and systemic therapeutic approaches. Here we discuss an unusual case of a 61-year-old male patient who presented with a brain metastasis as the initial disease presentation and the presumed primary lesion was later found in the gastrointestinal tract and the scalp. Treatment consisted of a surgical removal of the large intracranial lesion. Further evaluation for primary lesion was done by general physical examination, contrast-enhanced computed tomography (CECT) of the chest and whole abdomen. Apart from that, colonoscopy was done, and a biopsy was taken from a suspicious colonic lesion. The scalp pigmented lesion was also evaluated. Both biopsies were in favor of melanoma. Recently, management of metastatic melanoma of the brain is decided according to the number of lesions, accessibility, visceral metastasis, and resectability of the lesion. Various treatment options are surgical resection, whole brain radiotherapy (WBRT) and stereotactic radiosurgery (SRS). Malignant melanoma is relatively radioresistant, so the results are debatable. In conclusion, the prognosis of intracranial malignant melanoma is determined by the following factors: (1) the type of lesion; (2) the involvement of the leptomeninges; (3) the extent of tumor excised; and (4) the molecular immunology borstel number 1 (MIB 1) antibody index, which is the most relevant factor for prognosis in this type of cancer.

Keywords

melanoma - surgical resection - WBRT - SRS


Publication History

Article published online:
07 August 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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