Brain Metastasis as Initial Manifestation of Melanoma (A Case Report)

Vitorino Modesto Santos; Renata Faria Silva; Viviane Vieira Passini; Mayza Lemes Duarte; Leandro Pretto Flores

doi:10.15562/bmj.v5i2.149

Brain Metastasis as Initial Manifestation of Melanoma (A Case Report)

Vitorino Modesto Santos ,

Renata Faria Silva ,

Viviane Vieira Passini ,

Mayza Lemes Duarte ,

Leandro Pretto Flores ,

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DOI: https://doi.org/10.15562/bmj.v5i2.149 |
Published: 2016-06-28

Abstract

Background: Melanoma is a malignancy derived from the neural crest, constituted of melanocytes found in the basal layer of epidermis, with the main function of melanin production. Case: A 64-year-old woman was admitted with headache and dyslalia and reported some episodes of vertigo and falls in the last six months. A superficial red and dark skin discoloration in the scalp and a node in the right parotid gland were observed. Computed tomography of the brain showed nodular lesions in the left parietal and right temporal and occipital lobes with hemorrhagic features, in addition to mass effect. Furthermore, PET-CT images were suggestive of brain, lung, and adrenal metastasis. The patient evolved with intracranial hypertension and a neurosurgery was performed. Histopathological and immunohistochemistry studies revealed metastatic melanoma. Conclusions: She underwent schedules of radiation therapy and chemotherapy, but developed uncontrolled sepsis and died in spite of clinical management and intensive care support. Cutaneous primary site of this malignancy in the scalp was previously neglected; therefore, neurological disturbances were the initial manifestations of melanoma. Immunohistochemistry findings allowed ruling out the main differential hypotheses.

References

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Sperduto PW, Kased N, Roberge D, Xu Zhiyuan, Shanley R, Luo X, et al. Summary report on the graded prognostic assessment: an accurate and facile diagnosis-specific tool to estimate survival for patients with brain metastases. J Clin Oncol. 2012;30(4):419-25.
Goulart CR, Mattei TA, Ramina R. Cerebral melanoma metastases: a critical review on diagnostic methods and therapeutic options. ISRN Surg. 2011;2011:276908.
Hong Zhu, Dandan Dong, Fanghua Li, Dandan Liu, Lei Wang, Jing Fu MM, et al. Clinicopathologic features and prognostic factors in patients with non-cutaneous malignant melanoma: a single-center retrospective study of 71 cases. Int J Dermatol. 2015;54(12):1390-5
Ishida M, Iwai M, Yoshida K, Kagotani A, Okabe H. Rhabdoid melanoma: a case report with review of the literature. Int J Clin Exp Pathol. 2014;7(2):840-3.
Liang Z-P, Xu S-E, Jiang J, Zhao C, Sun X-Q, Qin G. Scalp junctional nevus with malignant transformation (melanoma) metastasis to parotid lymph node region, cervical lymph nodes and the back: a case report and review of literature. Int Clin Exp Pathol. 2015;8:954-9.
Thom JJ, Moore EJ, Price DL, Kasperbauer JL, Starkman SJ, Olsen KD. The role of parotidectomy for metastatic cutaneous squamous cell carcinoma and malignant melanoma. JAMA Otolaryngol Head Neck Surg. 2014;140(6):548-54.

[1] Patnayak R, Jena A, Vijaylaxmi B, Lakshmi AY, Prasad BMC, ChowhanAK, et al. Metastasis in central nervous system: clinicopathological study with review of literature in a tertiary care center in South India. South Asian J Cancer. 2013;2(4):245-9.

[2] Sperduto PW, Kased N, Roberge D, Xu Zhiyuan, Shanley R, Luo X, et al. Summary report on the graded prognostic assessment: an accurate and facile diagnosis-specific tool to estimate survival for patients with brain metastases. J Clin Oncol. 2012;30(4):419-25.

[3] Goulart CR, Mattei TA, Ramina R. Cerebral melanoma metastases: a critical review on diagnostic methods and therapeutic options. ISRN Surg. 2011;2011:276908.

[4] Hong Zhu, Dandan Dong, Fanghua Li, Dandan Liu, Lei Wang, Jing Fu MM, et al. Clinicopathologic features and prognostic factors in patients with non-cutaneous malignant melanoma: a single-center retrospective study of 71 cases. Int J Dermatol. 2015;54(12):1390-5

[5] Ishida M, Iwai M, Yoshida K, Kagotani A, Okabe H. Rhabdoid melanoma: a case report with review of the literature. Int J Clin Exp Pathol. 2014;7(2):840-3.

[6] Liang Z-P, Xu S-E, Jiang J, Zhao C, Sun X-Q, Qin G. Scalp junctional nevus with malignant transformation (melanoma) metastasis to parotid lymph node region, cervical lymph nodes and the back: a case report and review of literature. Int Clin Exp Pathol. 2015;8:954-9.

[7] Thom JJ, Moore EJ, Price DL, Kasperbauer JL, Starkman SJ, Olsen KD. The role of parotidectomy for metastatic cutaneous squamous cell carcinoma and malignant melanoma. JAMA Otolaryngol Head Neck Surg. 2014;140(6):548-54.

Brain Metastasis as Initial Manifestation of Melanoma (A Case Report)

Abstract

References

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