J Korean Neurosurg Soc.  2017 Jan;60(1):98-101. 10.3340/jkns.2015.0506.007.

Primary Intracranial Malignant Melanoma with Extracranial Metastasis

• Hirota K
• Yoshimura
• Kubo O
• Kasuya H

• KMID: 2365594
• DOI: http://doi.org/10.3340/jkns.2015.0506.007

Abstract

We report a case of primary intracranial malignant melanoma (PIMM) with extracranial metastases. The patient was an 82-year-old woman diagnosed with PIMM under the left cerebellar tentorium. We performed a tumor resection followed by gamma knife surgery. An magnetic resonance imaging at 11 months after surgery showed a local intracranial recurrence. At 12 months, vertebral metastasis was suspected, and 2-[fluorine-18]-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT) showed multiple extracranial metastases. She died at 13 months after surgery. Although extracranial metastases of PIMM are extremely rare, we should carefully follow up extracranial metastases together with intracranial ones, especially by FDG-PET/CT, even at an early asymptomatic stage.

Keyword

Intracranial malignant melanoma; Extracranial metastasis; Positron emission tomography

MeSH Terms

Aged, 80 and over
Electrons
Female
Follow-Up Studies
Humans
Magnetic Resonance Imaging
Melanoma*
Neoplasm Metastasis*
Positron-Emission Tomography
Recurrence

Figure

• 

  Fig. 1 Axial T1-weighted MRI (A) shows an extra-axial mass lesion under the left cerebellar tentorium one month before admission. Axial CT (B), T1-weighted MRI (C) and Coronal Gd-enhanced T1-weighted MRI (D) on admission show the enlarged mass lesion with niveau formation at one month later. MRI: magnetic resonance imaging, CT: computed tomography.

• 

  Fig. 2 Whole body FDG-PET/CT (A) on admission shows no malignant lesions such as extracranial malignant melanoma. FDG-PET/CT (B) at 12 months after the surgery shows FDG uptake in multiple metastatic lesions. FDG-PET/CT: 2-[fluorine-18]-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography.

• 

  Fig. 3 Intraoperative image (A) shows the black colored tumor on the left cerebellar tentorium. Photomicrographs. The tumor cells arranged in fascicles intersperse with melanin-containing cells (B, H&E, ×200). The tumor cells are positive for Melan-A (C, ×400). The MIB-1 (Ki-67) staining index is approximately 8% (D, ×400).

Reference

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