Unusual intracranial melanoma: a case report

Abstract

Introduction: Melanomas are malignant cutaneous melanocytes tumors. They have great potential to metastasize. The third most frequent site is the cerebral parenchyma (20% - 25%). Usually, intracranial metastases occur in most advanced cancer. About 50% of the metastases cancer are asymptomatic. This paper aims to illustrate the difficulties in brain expansive lesions diagnosis, reporting one tumor case. Case report: A forty-three-year-old man had an acute insidious onset of a chronic headache at the bitemporal region, with irradiation to the occipital region. He underwent CT, which has shown an expansive lesion in the posterior cranial fossa, on the left side, which presented a hypertensive hematoma. A craniectomy was performed, revealing a blackened and bleeding injury, discarding the hypothesis of hypertensive hematoma, with pathology confirming the diagnosis of melanoma. Discussion: Many cases do not present clinical manifestations, and the mass effect could happen in tumor cases, primary or metastasis or stroke bleeding lesions. In cases with suspected metastases, gadolinium magnetic resonance is the best method to rule out differential diagnoses, and surgical resection is considered the standard reference in treatment. Conclusion: Brain metastases of melanomas could present several different diagnoses in different locations. Es esencial que el equipo neuroquirúrgico piense alguna vez en estas lesiones como un diagnóstico diferencial en las lesiones hemorrágicas agudas.