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

Vitorino Modesto Santos
Catholic University and Armed Forces Hospital, Brasília-DF, Brazil. Email: [email protected]

Renata Faria Silva
Armed Forces Hospital, Brasília-DF, Brazil

Viviane Vieira Passini
Armed Forces Hospital, Brasília-DF, Brazil

Mayza Lemes Duarte
Armed Forces Hospital, Brasília-DF, Brazil

Leandro Pretto Flores
Armed Forces Hospital, Brasília-DF, Brazil
Online First: June 28, 2016 | Cite this Article
Santos, V., Silva, R., Passini, V., Duarte, M., Flores, L. 2016. Brain Metastasis as Initial Manifestation of Melanoma (A Case Report). Bali Medical Journal 5(2): 295-297. DOI:10.15562/bmj.v5i2.149

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.


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