Limits...
Intracranial hemorrhagic metastases as the first manifestation of an occult melanoma.

Reddy VU, Suneetha P, Shanthi V, Murali Mohan KV, Agrawal A - South Asian J Cancer (2015 Apr-Jun)

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Narayana Medical College Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, India.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Dear Editor, Brain metastases from malignant melanoma are common, and it result in severe morbidity and mortality... Approximately, 10–40% of patients with melanoma develop brain metastasis (autopsy rates are much higher), and 50% of melanoma brain metastases (MBM) turn hemorrhagic... Patient was a known alcoholic and smoker for 35 years... He had recent complaints of decreased appetite and irregular bowel, bladder habits... In view of poor neurological status, the patient was intubated... Plain computed tomography (CT) scan brain showed a well-defined heterogeneous mass with hemorrhage in the left parieto-occipital region with adjacent vasogenic edema and mass effect [Figure 1a-c, upper row]... The patient was kept on elective ventilation and could be weaned off on day 2 post-surgery... The patient became conscious, and his power improved to almost normal... Clinical symptoms include frequent headaches and other symptoms of raised intracranial pressure, seizures, and focal neurological deficits... Variegated appearance, heterogeneous enhancement should help us diagnosis tumoral hemorrhage... Prime role of surgery is to do debulk the tumor and reduce vasogenic edema, mass effect, local recurrence can be treated with surgery and adjuvant whole brain radiotherapy... MBM'S have extremely grave prognosis and the reported median survival rate for patients treated with surgery and radiotherapy is 8.9 months... Although approximately 50% of MBM turn hemorrhagic but melanoma presenting with neurological deficits and focal weakness is an uncommon first manifestation... In such cases, removal of intracranial mass may not increase the survival; however, it can improve the quality-of-life of the survivors.

No MeSH data available.


Related in: MedlinePlus

(Upper row) Well-defined hyperattenuating hemorrhagic mass in the left parieto-occipital region with adjacent vasogenic edema and mass effect as described, lower row (a) Hemorrhagic material with dispersed tumor cells (H and E, ×100), (b) tumor cell having hyperchromatic nuclei and cytoplasm with brown-black pigment (H and E, ×400) and (c) Hemorrhagic material with dispersed hemosiderin-laden macrophages (H and E, ×400)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4418076&req=5

Figure 1: (Upper row) Well-defined hyperattenuating hemorrhagic mass in the left parieto-occipital region with adjacent vasogenic edema and mass effect as described, lower row (a) Hemorrhagic material with dispersed tumor cells (H and E, ×100), (b) tumor cell having hyperchromatic nuclei and cytoplasm with brown-black pigment (H and E, ×400) and (c) Hemorrhagic material with dispersed hemosiderin-laden macrophages (H and E, ×400)

Mentions: A 55-year-old male presented with altered sensorium, headache, and weakness of right upper and lower limb since 1 day. Patient was a known alcoholic and smoker for 35 years. He had recent complaints of decreased appetite and irregular bowel, bladder habits. On examination, he was drowsy and arousable, pupils were sluggish and reactive to light. Motor examination revealed 3/5 power in right upper and lower limbs. He was localizing on the left side. On chest examination, he had bilateral crepitation and conducted sounds. In view of poor neurological status, the patient was intubated. Plain computed tomography (CT) scan brain showed a well-defined heterogeneous mass with hemorrhage in the left parieto-occipital region with adjacent vasogenic edema and mass effect [Figure 1a-c, upper row]. His chest X-ray was normal. A differential diagnosis of tumor with bleed and hypertensive bleed was considered. The patient was started on anti-edema measures and anti-epileptics. The patient underwent left parieto-occiptial craniotomy and total decompression of the lesion. Intraoperatively, there thick dark color clotted blood with tumor tissue. The patient was kept on elective ventilation and could be weaned off on day 2 post-surgery. The patient became conscious, and his power improved to almost normal. Histopathology showed metastatic carcinomatous deposit showing dispersed tumor cells having hyperchromatic nuclei of varying sizes, prominent eosinophilic nuclei, cytoplasm was showing brown to black pigment [Figure 1a-c, lower row].


Intracranial hemorrhagic metastases as the first manifestation of an occult melanoma.

Reddy VU, Suneetha P, Shanthi V, Murali Mohan KV, Agrawal A - South Asian J Cancer (2015 Apr-Jun)

(Upper row) Well-defined hyperattenuating hemorrhagic mass in the left parieto-occipital region with adjacent vasogenic edema and mass effect as described, lower row (a) Hemorrhagic material with dispersed tumor cells (H and E, ×100), (b) tumor cell having hyperchromatic nuclei and cytoplasm with brown-black pigment (H and E, ×400) and (c) Hemorrhagic material with dispersed hemosiderin-laden macrophages (H and E, ×400)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4418076&req=5

Figure 1: (Upper row) Well-defined hyperattenuating hemorrhagic mass in the left parieto-occipital region with adjacent vasogenic edema and mass effect as described, lower row (a) Hemorrhagic material with dispersed tumor cells (H and E, ×100), (b) tumor cell having hyperchromatic nuclei and cytoplasm with brown-black pigment (H and E, ×400) and (c) Hemorrhagic material with dispersed hemosiderin-laden macrophages (H and E, ×400)
Mentions: A 55-year-old male presented with altered sensorium, headache, and weakness of right upper and lower limb since 1 day. Patient was a known alcoholic and smoker for 35 years. He had recent complaints of decreased appetite and irregular bowel, bladder habits. On examination, he was drowsy and arousable, pupils were sluggish and reactive to light. Motor examination revealed 3/5 power in right upper and lower limbs. He was localizing on the left side. On chest examination, he had bilateral crepitation and conducted sounds. In view of poor neurological status, the patient was intubated. Plain computed tomography (CT) scan brain showed a well-defined heterogeneous mass with hemorrhage in the left parieto-occipital region with adjacent vasogenic edema and mass effect [Figure 1a-c, upper row]. His chest X-ray was normal. A differential diagnosis of tumor with bleed and hypertensive bleed was considered. The patient was started on anti-edema measures and anti-epileptics. The patient underwent left parieto-occiptial craniotomy and total decompression of the lesion. Intraoperatively, there thick dark color clotted blood with tumor tissue. The patient was kept on elective ventilation and could be weaned off on day 2 post-surgery. The patient became conscious, and his power improved to almost normal. Histopathology showed metastatic carcinomatous deposit showing dispersed tumor cells having hyperchromatic nuclei of varying sizes, prominent eosinophilic nuclei, cytoplasm was showing brown to black pigment [Figure 1a-c, lower row].

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Narayana Medical College Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, India.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Dear Editor, Brain metastases from malignant melanoma are common, and it result in severe morbidity and mortality... Approximately, 10–40% of patients with melanoma develop brain metastasis (autopsy rates are much higher), and 50% of melanoma brain metastases (MBM) turn hemorrhagic... Patient was a known alcoholic and smoker for 35 years... He had recent complaints of decreased appetite and irregular bowel, bladder habits... In view of poor neurological status, the patient was intubated... Plain computed tomography (CT) scan brain showed a well-defined heterogeneous mass with hemorrhage in the left parieto-occipital region with adjacent vasogenic edema and mass effect [Figure 1a-c, upper row]... The patient was kept on elective ventilation and could be weaned off on day 2 post-surgery... The patient became conscious, and his power improved to almost normal... Clinical symptoms include frequent headaches and other symptoms of raised intracranial pressure, seizures, and focal neurological deficits... Variegated appearance, heterogeneous enhancement should help us diagnosis tumoral hemorrhage... Prime role of surgery is to do debulk the tumor and reduce vasogenic edema, mass effect, local recurrence can be treated with surgery and adjuvant whole brain radiotherapy... MBM'S have extremely grave prognosis and the reported median survival rate for patients treated with surgery and radiotherapy is 8.9 months... Although approximately 50% of MBM turn hemorrhagic but melanoma presenting with neurological deficits and focal weakness is an uncommon first manifestation... In such cases, removal of intracranial mass may not increase the survival; however, it can improve the quality-of-life of the survivors.

No MeSH data available.


Related in: MedlinePlus