Malignant melanoma of the cerebello-pontine angle region

Abstract

SUMMARY -A case of malignant melanoma in the cerebello-pontine angle region is presented in a 72 years old female patient, who had neurological examination and CT scan suggestive of acoustic neuroma.The surgical finding and the histological examination provided the diagnosis. As a primary focus was not found on clinical examination and although autopsy was not carried out, there is a possibility of the diagnosis being a primary malignant melanoma in CNS. This specific location for this kind of tumor was found to be rare when literature is looked up. Melanoma maligno da região do ângulo ponto-cerebelar.RESUMO -Registro de caso de melanoma maligno na região do ângulo ponto-cerebelar em paciente do sexo feminino, com 72 anos de idade, com exame neurológico e tomografia computadorizada sugestivos de neurinoma do acústico, em que o diagnóstico foi estabelecido pelo achado cirúrgico e pelo exame histopatológico. Como não foi achado foco primário no exame clínico e embora não tenha sido feita autopsia, há possibilidade de que o diagnóstico seja de melanoma maligno primário no sistema nervoso central.Esta localização particular desse tipo de tumor é considerada rara, levando em conta os dados da literatura.Malignant melanoma generally occurs in the Caucasian population (98%), represents about 1% of the neoplasias in general, and is responsable for 1% of deaths due to neoplasias.The greatest incidence occurs between the ages of 35 and 50, and after diagnosis one may expect a 5 year life expectancy in 67% of cases 13,41 These tumors present a high degree of metastatization in all organs of the body, mainly in CNS, where they constitute the third commonest cause of metastasis 2,18,31. Patients with skin melanomas may reveal 6 to 11% metastasis in the CNS during evolution, and this percentage may increase up to 90% in autopsies 2,31,43.in the SNC metastasis occurs more frequently in the brain hemispheres 22.The occurrence of primary malignant melanomas in the CNS has been reported to reach the pituitary, pineal gland, choroid plexus, cerebellum, cisterna magna and Sylvian fissure 9,17,21,34, 36,37,39.When primary they arise from melanocytes present in leptomeninges of the brain convexity or at the base, in the posterior fossa, in the spinal cervical canal, the coverings of the pia-mater vessels, the reticular formation of the pons and medulla, substantia nigra and locus coerulleus 21,24,25,45. We report a case of a large malignant melanoma of the cerebello-pontine angle (CPA) with a very similar appearance of acoustic neuroma in the computerized tomography (CT). Although autopsy was not performed it could be a primary melanoma, as no other focus was detected. CASE REPORTIG, a 72 years old female patient started having vertigo and progressive deafness in the right ear about IS months ago. More recently, two months ago, she developed gait disturbance with tendency to veer to the right side, mental deterioration, and loss of urine

Cerebellopontine angle metastasis from clear-cell renal carcinoma presenting as bleeding from the ear

“…The primary site of malignancy in patients with a CPA metastasis is often lung (Nelson and Dolan, 1991), prostate (Flickinger et al, 1989), lymphoma (Nakada et al, 1983) or malignant fibrous xanthoma (Jahrsdoerfer et al, 1976). Metastatic melanoma presenting as a CPA lesion has been reported and is noted to have a special predilection for the internal meatus (Berman et al, 1979;Braga et al, 1989). Clear-cell adenocarcinoma (diethylstilboestrol-related) of the cervix and vagina has been reported to metastasize to the cerebellum and CPA after a long delay (Burks et al, 1990).…”

Melanoma maligno primario del sistema nervioso central: un reto diagnóstico

“…Se presenta en un rango de edad entre 35 a 50 años 7 . Bhandari et al 2 refieren que fue Virchow quien, en 1859, describió el primer caso de melanoma intracraneal primario difuso, y Oogle reportó en 1899 el primer caso de melanoma primario solitario intracraneal 7,8 . Estos tumores surgen de melanocitos presentes en las leptomeninges de la convexidad cerebral, de la base del cráneo, fosa posterior, canal cervical espinal, la piamadre que recubre los vasos, formación reticular del puente y médula, sustancia negra y locus coerulleus 7 .…”

Management and Prognosis of Primary Cerebral Melanocytic Tumors. A Case Report and Systematic Review

“…Based on title, abstract, and keywords, 38 articles were selected as potentially relevant, and these were obtained in a full text. After excluding intracranial secondary neoplasm and spinal localization of the disease, 14 articles remained for further analysis 3,[5][6][7][8][9][10][11][12][13][14][15][16][17] (►Table 1),…”