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J Neurooncol (2009) 93:413420 DOI 10.1007/s11060-008-9785-0
CASE REPORT
Multiple intracranial melanoma metastases: case report and review of the literature
Aslan Guzel Jaroslaw Maciaczyk Hildegard Dohmen-Scheuer Senem Senturk Benedikt Volk Christoph B. Ostertag Guido Nikkhah
Received: 15 July 2008 / Accepted: 30 December 2008 / Published online: 1 February 2009 Springer Science+Business Media, LLC. 2009
Abstract Although intracerebral metastases of malignant melanoma are common, those located in the sellar region and within the pontocerebellar area are extremely rare. Furthermore, to our knowledge, there is no report about melanoma metastasis to the epiphysis published so far. We report here a 46-year-old patient who had metastatic lesions in the sellar region, cerebellopontine area and epiphysial gland, preceded by a primary melanoma at her left shoulder. The diagnosis of sellar metastasis was conrmed histopathologically following a stereotactic biopsy. The patient received whole-brain irradiation therapy combined with chemotherapy. After 10 months, she died from a
severe hemorrhage in the cerebellopontine angle. Autopsy ndings conrmed melanoma metastases both in the cerebellopontine angle and additionally in the epiphysial gland. To our knowledge, this is the rst case of multiple intracranial melanoma metastases including the suprasellar region, the pontocerebellar and epiphysial area.
Keywords Cerebellopontine area Epiphysis
Multiple melanoma metastases Sellar region
Introduction
Melanomas are the third most common source of intracranial metastases after breast and lung carcinomas [13]. The incidence of central nervous system (CNS) metastases in patients with melanomas ranges from 10% to 40% in clinical studies and is even higher in autopsy series, with as many as two-thirds of patients with metastatic melanoma having CNS involvement [4]. They are also the major cause of morbidity and mortality, leading directly to death in as many as 95% of the patients [5, 6]. Intracranial secondary spread of melanoma is frequently multiple [4, 7]. Although malignant melanomas are known to have a high propensity to metastasize to the brain, involvement of both the sellar region and the cerebellopontine area (CPA) is extremely rare [815]. In general, tumor metastases to the sellar area are an unusual complication of systemic cancer typically seen in elderly patients with diffuse malignant disease [10]. Concerning the sellar spread of neoplasia, breast and lung cancers are the most common primary tumors [16, 17]. Interestingly, only 16 cases of metastasis to...