[Cerebral metastasis of melanoma: study of 48 patients]. / Metástasis cerebrales de melanoma: estudio de 48 pacientes.

ABSTRACT

BACKGROUND: Malignant melanoma is a frequent cause of cerebral metastases (CM). In the present study the characteristics of primitive melanomas of patients with CM, their forms of clinical presentation and treatment were analyzed. METHODS: A retrospective study of the patients with melanoma and CM diagnosed between 1982 and 1991 was carried out. RESULTS: Out of 786 patients with melanoma 48 were identified with CM. In 65% of the melanoma originated in cutaneous areas BANS (of bad prognosis). The median thickness of the tumor (Breslow's index) was of 3.6 mm. The median period of latency between diagnosis of the melanoma and the detection of CM was 22 months. Although recent hemorrhage of the CM was observed in the cranial computerized tomography in 20 of the 48 patients, only 7 presented clinical symptoms of ictus. In 23 patients the CM were the only evidence of metastases of the melanoma. The median survival was one month in the patients treated with only dexamethasone, 3.5 months in the chemotherapy group, 2.5 months for the group given radiotherapy and 6 months for those undergoing surgery. CONCLUSIONS: Most of the patients with cerebral metastasis had a primitive melanoma with criteria of bad prognosis. The presence of hemorrhage in computerized tomography did not always correlate with clinical symptoms of ictus. Surgical treatment must be considered in patient with sole cerebral metastasis without evidence of distant disease.