CEREBRAL METASTASES OF MELANOMA - STUDY O F 48 PATIENTS

BACKGROUND: Malignant melanoma is a frequent cause of cerebral metasta ses (CM). In the present study the characteristics of primitive melano mas of patients with CM, their forms of clinical presentation and trea tment were analyzed. METHODS: A retrospective study of the patients wi th melanoma and CM diagnosed between 1982 and 1991 was carried out. RE SULTS: Out of 786 patients with melanoma 48 were identified with CM. I n 65 % of the melanoma originated in cutaneous areas BANS (of bad prog nosis). The median thickness of the tumor (Breslow's index) was of 3.6 mm. The median period of lactency between diagnosis of the melanoma a nd the detection of CM was 22 months. Although recent hemorrhage of th e CM was observed in the craneal computerized tomography in 20 of the 48 patients, only 7 presented clinical symptoms of ictus. In 23 patien ts the CM were the only evidence of metastases of the melanoma. The me dian survival was one month in the patients treated with only dexameth asone, 3.5 months in the chemotherapy group, 2.5 months for the group given radiotherapy and 6 months for those undergoing surgery. CONCLUSI ONS: Most of the patients with cerebral metastasis had a primitive mel anoma with criteria of bad prognosis. The presence of hemorrhage in co mputerized tomography did not always correlate with clinical symptoms of ictus. Surgical treatment must be considered in patient with sole c erebral metastasis without evidence of distant disease.