Solitary cerebral metastasis from melanoma: value of the 'en bloc' resection

Clin Neurol Neurosurg. 1996 Feb;98(1):12-4. doi: 10.1016/0303-8467(95)00077-1.

Abstract

The authors report 19 cases of solitary cerebral metastases from malignant melanoma. In 15 patients, the primary lesion was known at the time the metastasis was diagnosed; deltoid-scapular in 4 cases, thoracic in 5, inguinal in 4 and neck in 2. The primary location was unknown in 4 patients. Presenting symptoms were: epileptic seizures in 9 cases, headache in 8, strength deficit of the limbs in 2. In 3 patients (16%) neurological symptoms were the first clinical sign of the systemic tumor; in 16 cases (84%) there was a long interval between treatment of the primary and appearance of the cerebral metastasis (average 3.8 years; median 3.4 years). All patients were submitted to surgery and radiotherapy (whole-brain in 14 and radiosurgery in 5). In 10 cases the lesion was removed 'en bloc' (no internal touch technique). Average survival was 9 months (median 8 months) and was influenced by 'en bloc' resection and whole-brain irradiation. None of the patients operated by the 'no touch technique' presented a recurrence.

MeSH terms

  • Adult
  • Aged
  • Brain Neoplasms / pathology*
  • Brain Neoplasms / radiotherapy
  • Brain Neoplasms / secondary*
  • Brain Neoplasms / surgery*
  • Cranial Fossa, Posterior / pathology*
  • Cranial Fossa, Posterior / surgery*
  • Female
  • Humans
  • Male
  • Melanoma / pathology*
  • Melanoma / radiotherapy
  • Melanoma / surgery*
  • Middle Aged
  • Neoplasm Metastasis*
  • Neoplasm Recurrence, Local