A 41-Year-Old Woman with a Late Cerebral Metastasis 16 Years After an Initial Diagnosis of Cutaneous Melanoma

Patient: Female, 41-year-old Final Diagnosis: Melanoma brain metastasis Symptoms: Intrercranial hemorraghe Medication:— Clinical Procedure: — Specialty: Neurosurgery OBJECTIVE: Rare disease BACKGROUND: Late cerebral metastasis more than 10 years after the diagnosis of cutaneous melanoma is very rare. This report is of a woman with late cerebral metastasis 16 years after an initial diagnosis of cutaneous melanoma. CASE REPORT: A 41-year-old woman had been diagnosed with malignant melanoma 16 years prior from a biopsy of a dish-pattern tumor on the back, for which she received chemotherapy for 5 times (therapeutic regimen and medications were not available). She had not had a diagnosis of skin melanoma in the past 16 years. Before presentation to the Emergency Department, she had a progressive disturbance of consciousness for 6 weeks and sudden coma for 6 h. A head computed tomography scan indicated intracranial masses located at the right frontal and temporal lobes. The patient underwent surgery for tumor and hematoma removal. During surgery, dural metastasis with widespread dissemination in adjacent temporal bone, temporalis, and hypodermis was confirmed. Postoperative histopathology analysis confirmed the diagnosis of malignant melanoma metastasis. On the second day after surgery, the patient developed recurrent bleeding in the right frontal lobe, which led to deteriorated consciousness. She received hematoma evacuation and craniectomy and lived in a poor condition with drowsiness and hemiplegia of the left limb for 3 months and died 5 months after craniectomy. CONCLUSIONS: This report has presented a rare occurrence of late cerebral metastasis 16 years after the initial diagnosis of a primary cutaneous melanoma. More recent primary melanoma of the skin was not identified, which supports the need for long-term follow-up of patients with a history of primary cutaneous melanoma.