COMPUTED-TOMOGRAPHY FEATURES OF CEREBRAL SPREAD OF MALIGNANT-MELANOMA

The CT features of cerebral involvement by metastatic malignant melano ma are described in 28 patients. The most common locations of the prim ary lesion were the trunk and lower limbs. There was a high incidence of extracerebral metastasis at the time of diagnosis of cerebral invol vement. Headache and behavioral changes were the most frequent present ing symptoms; 7% of patients were asymptomatic. The cerebral metastase s were classified by size (<1 cm, 1-4 cm, >4 cm), with more than half measuring 1-4 cm. The larger lesions usually occurred singly. Peritumo ral edema was detected in 89% of patients, hemorrhage in 19%, pressure signs on the ventricles in 37%, midline deviation in 15%, and leptome ningeal spread in 11%. No correlation was noted between size of tumor and other radiological features. Unilateral involvement was documented in 44% of cases. In the majority of patients the metastases were loca ted at the periphery of the brain, mostly in the temporal and parietal lobes. Neuroimaging studies of the brain in asymptomatic patients wit h malignant melanoma may reveal occult metastases and influence the ch oice of treatment.