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Cerebral melanoma

Lea Bottlaender, Marie Perier-Muzet, Véronique Lapras, Luc Thomas, Stephane Dalle
BRAF inhibitors (vemurafenib and dabrafenib) are nowadays commonly prescribed in BRAF-mutant metastatic melanoma and allow improvement of the overall survival and progression-free survival. They are, however, accompanied by many adverse effects which mainly affect the skin. We observed on computed tomographic scans in three different patients after 3 months of treatment, the onset of osteosclerotic lesions. In parallel, the computed tomographic scans showed a significant reduction in all of the previously identified metastases in all patients...
October 18, 2016: Melanoma Research
E Liniker, A M Menzies, B Y Kong, A Cooper, S Ramanujam, S Lo, R F Kefford, G B Fogarty, A Guminski, T W Wang, M S Carlino, A Hong, G V Long
The anti-PD-1 antibodies nivolumab and pembrolizumab are active in metastatic melanoma; however, there is limited data on combining anti-PD-1 antibody and radiotherapy (RT). We sought to review clinical outcomes of patients receiving RT and anti-PD-1 therapy. All patients receiving anti-PD-1 antibody and RT for metastatic melanoma were identified. RT and systemic treatment, clinical outcome, and toxicity data were collected. Fifty-three patients were included; 35 patients received extracranial RT and/or intracranial stereotactic radiosurgery (SRS) and 21 received whole brain radiotherapy (WBRT) (three of whom also received SRS/extracranial RT)...
2016: Oncoimmunology
Giancarlo D'Andrea, Lucia Palombi, Giuseppe Minniti, Alessandro Pesce, Paolo Marchetti
OBJECTIVE: Brain metastases occur between 10 and 40% of patients with cancer and are more common than primary brain tumors (30-40%) and their incidence is growing because of the improvements in control of systemic disease, the prolonged survival and the better radiological detection. Modern treatment of brain metastases dramatically changed their expected prognosis that traditionally has been considered very poor referring such patients only to palliation because their terminal stage, and new prognostic indexes have been proposed to evaluate them...
September 22, 2016: World Neurosurgery
Alina Basnet, Nibal Saad, Sam Benjamin
BACKGROUND: Melanoma is among the top three cancers to present with brain metastasis. The risk of brain metastases in advanced melanoma increases with disease duration. Cytotoxic chemotherapy does not have a significant role in the management of melanoma patients with brain metastases, neither alone nor in conjunction with radiation therapy. PATIENTS AND METHODS: We herein discuss a case of a 66-year-old male diagnosed initially with stage III-B melanoma and underwent a wide local excision with a split thickness graft and sentinel lymph node biopsy, followed by adjuvant treatment with high-dose interferon...
September 2016: Anticancer Research
Marta Troya-Castilla, Santiago Rocha-Romero, Yamin Chocrón-González, Francisco Javier Márquez-Rivas
BACKGROUND: Primary brain melanomas are very infrequent and metastasis outside central nervous system very uncommon. There are some cases in the literature about primary melanoma in the temporal lobe; nevertheless, the insular location has never been described. CASE PRESENTATION: The patient presented as left insular intraparenchymal hematoma with multiple bleedings. Complementary tests did not show any tumoral nor vascular pattern in relation with these bleedings...
2016: World Journal of Surgical Oncology
Juliano N Navarro, Raphael V Alves
BACKGROUND: Cerebral myiasis is a rare parasitic disease, especially in postoperative neurological surgery. CASE DESCRIPTION: We report a case of postoperative myiasis in a patient who underwent a craniotomy for resection of metastatic melanoma, evolving with wound dehiscence due to myiasis in the operative wound. CONCLUSION: Myiasis infestation should be a differential diagnosis of surgical wound dehiscence, particularly when the classic signs of inflammation are not present and computed tomography of the brain shows signs suggestive of this disease entity...
2016: Surgical Neurology International
Wala Ben Kridis, Jihène Feki, Lobna Ayedi, Afef Khanfir, Nabil Toumi, Mohamed Abdelmoula, Tahia Boudawra, Jamel Daoud, Mounir Frikha
Primary melanoma of the mandibular gingiva is extremely rare. It is often misinterpreted as a benign pigmented process. The prognosis of this entity is very poor. We report here the first case of primary gingival melanoma described in the Tunisian literature about a 55-year-old smoker having cerebral and pulmonary metastases from gingival melanoma at diagnosis. Our patient underwent brain radiotherapy at a dose of 18 Gy in three sessions but he died with a decline of 3 months before starting systemic therapy...
July 2016: Journal of Maxillofacial and Oral Surgery
Felix Behling, Alonso Barrantes-Freer, Marco Skardelly, Maike Nieser, Arne Christians, Florian Stockhammer, Veit Rohde, Marcos Tatagiba, Christian Hartmann, Christine Stadelmann, Jens Schittenhelm
BACKGROUND: Treatment options for oncological diseases have been enhanced by the advent of targeted therapies. The point mutation of the BRAF gene at codon 600 (BRAF V600E) is found in several tumor entities and can be approached with selective inhibitory antibodies. The BRAF inhibitor vemurafenib has demonstrated clinical efficacy in patients with BRAF V600E-mutant melanoma brain metastases and in other cancer diseases. Therefore the BRAF V600E mutation is a highly interesting oncological target in brain tumors...
2016: Diagnostic Pathology
Heike Niessner, Jennifer Schmitz, Ghazaleh Tabatabai, Andreas Schmid, Carsten Calaminus, Tobias Sinnberg, Benjamin Weide, Thomas K Eigentler, Claus Garbe, Birgit Schittek, Leticia Quintanilla-Fend, Benjamin Bender, Marion Mai, Christian Praetorius, Stefan Beissert, Gabriele Schackert, Michael Muders, Matthias Meinhardt, Gustavo B Baretton, Reinhard Dummer, Keith T Flaherty, Bernd J Pichler, Dagmar Kulms, Dana Westphal, Friedegund Meier
PURPOSE: Great advances have recently been made in treating patients with metastatic melanoma. However, existing therapies are less effective on cerebral than extracerebral metastases. This highlights the potential role of the brain environment on tumor progression and drug resistance and underlines the need for "brain-specific" therapies. We previously showed that the PI3K-AKT survival pathway is hyperactivated in brain but not extracerebral melanoma metastases and that astrocyte-conditioned medium activates AKT in melanoma cells in vitro...
June 15, 2016: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Trude G Simonsen, Jon-Vidar Gaustad, Einar K Rofstad
INTRODUCTION: A majority of patients with melanoma brain metastases develop multiple lesions, and these patients show particularly poor prognosis. To develop improved treatment strategies, detailed insights into the biology of melanoma brain metastases, and particularly the development of multiple lesions, are needed. The purpose of this preclinical investigation was to study melanoma cell migration within the brain after cell injection into a well-defined intracerebral site. METHODS: A-07, D-12, R-18, and U-25 human melanoma cells transfected with green fluorescent protein were injected stereotactically into the right cerebral hemisphere of nude mice...
June 2016: Translational Oncology
A Gupta, P Prakash, A Rattan, N Wadhwa, S Kumar, V Rathi
Malignant melanoma of the anorectum is a rare but highly aggressive tumor. We report our experience of anorectal melanoma in five patients. Of these, two have advanced disease, two had localized disease and one patient had florid systemic metastases with a history of hemorrhoidectomy one year prior. One patient whose metastatic workup was negative, expired on post-op day 15 of abdominoperineal resection due to unsuspected but florid cerebral metastases. Another patient with localized disease underwent an APR with curative resection and post-op whole body PET scan negative for occult or residual disease...
May 2016: Gulf Journal of Oncology
Alireza M Mohammadi, Jason L Schroeder, Lilyana Angelov, Samuel T Chao, Erin S Murphy, Jennifer S Yu, Gennady Neyman, Xuefei Jia, John H Suh, Gene H Barnett, Michael A Vogelbaum
OBJECTIVE The impact of the stereotactic radiosurgery (SRS) prescription dose (PD) on local progression and radiation necrosis for small (≤ 2 cm) brain metastases was evaluated. METHODS An institutional review board-approved retrospective review was performed on 896 patients with brain metastases ≤ 2 cm (3034 tumors) who were treated with 1229 SRS procedures between 2000 and 2012. Local progression and/or radiation necrosis were the primary end points. Each tumor was followed from the date of radiosurgery until one of the end points was reached or the last MRI follow-up...
May 27, 2016: Journal of Neurosurgery
R Rauschenberg, G Tabatabai, E G C Troost, M Garzarolli, S Beissert, F Meier
The majority of patients with metastatic melanoma will develop brain metastases, which are the most common cause of death. Until recently, local therapies (e. g., neurosurgery, radiotherapy) were the only options for brain metastases; however, effective systemic treatment options are now available. Upon suspicion of brain metastases, diagnostic staging with brain MRI and a neurological investigation are indicated. Prognostic factors such as number of cerebral metastases and symptoms, serum lactate dehydrogenase and S‑100 levels, extracerebral metastases, and ECOG status are considered during therapeutic planning...
July 2016: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
Mark P Breazzano, Ann E Barker-Griffith
BACKGROUND/AIMS: To report a case of cutaneous malignant melanoma with cerebral metastasis found to have vitreoretinal metastasis upon referral for neovascular glaucoma. METHODS: The clinical history and ocular examination findings, including histologic, cytologic, genetic, and immunohistochemical features of the vitreoretinal metastatic tumor, were reviewed. Additionally, the histologic and immunohistochemical features of the primary skin tumor and brain metastasis were also assessed...
December 2015: Ocular Oncology and Pathology
Laxminadh Sivaraju, Saritha Aryan, Vinay S Hegde, Nandita Ghosal, Alangar S Hegde
Malignant melanoma is the third most common tumour to cause cerebral metastases, following breast and lung cancer. Central nervous system metastases occur in 10-40% of patients with melanoma. Intracranial metastasis from a primary malignant melanoma of the anterior mediastinum is uncommon. We report a case of solitary intracranial metastatic melanoma arising from a primary mediastinal tumour. We then discuss the clinico-radiological features and treatment options.
August 2016: Neuroradiology Journal
Yingmei Li, Wenying Pan, Ian D Connolly, Sunil Reddy, Seema Nagpal, Stephen Quake, Melanie Hayden Gephart
Cerebral spinal fluid (CSF) from brain tumor patients contains tumor cellular and cell-free DNA (cfDNA), which provides a less-invasive and routinely accessible method to obtain tumor genomic information. In this report, we used droplet digital PCR to test mutant tumor DNA in CSF of a patient to monitor the treatment response of metastatic melanoma leptomeningeal disease (LMD). The primary melanoma was known to have a BRAF (V600E) mutation, and the patient was treated with whole brain radiotherapy and BRAF inhibitors...
May 2016: Journal of Neuro-oncology
Deborah C Marshall, Logan P Marcus, Teddy E Kim, Brandon A McCutcheon, Steven J Goetsch, Takao Koiso, John F Alksne, Kenneth Ott, Bob S Carter, Jona A Hattangadi-Gluth, Masaaki Yamamoto, Clark C Chen
With escalating focus on cost containment, there is increasing scrutiny on the practice of multiple stereotactic radiosurgeries (SRSs) for patients with cerebral metastases distant to the initial tumor site. Our goal was to determine the survival patterns of patients with cerebral metastasis who underwent multiple SRSs. We retrospectively analyzed survival outcomes of 801 patients with 3683 cerebral metastases from primary breast, colorectal, lung, melanoma and renal histologies consecutively treated at the University of California, San Diego/San Diego Gamma Knife Center (UCSD/SDGKC), comparing the survival pattern of patients who underwent a single (n = 643) versus multiple SRS(s) (n = 158) for subsequent cerebral metastases...
May 2016: Journal of Neuro-oncology
Jennifer Tan
A case of a young man diagnosed with perianal nodular melanoma with a gene mutation, accompanied by regional and pulmonary metastases on initial presentation, and later on with hepatic and bone involvement, is presented. The patient underwent wide local excision but was unresponsive to dacarbazine. Targeted therapy with vemurafenib had shown clinical improvement for a 5-month duration until he showed signs of disease progression. Just after the shift of adjuvant therapy to ipilimumab, he was diagnosed with multiple cerebral metastases that eventually led to his demise 6 months after initiation of vemurafenib, having had a 12-month survival period from the time of initial melanoma diagnosis...
2016: BMJ Case Reports
Nicolae Sarbu, Teresa Pujol, Laura Oleaga
Hyperintense perilesional edema in brain masses on T1-weighted images (T1WI) is an unusual radiological finding. We report three cases showing this particular type of edema, one representing cerebral hemorrhagic cavernous malformation (CCM, cavernoma) and the other two, metastases of melanoma. The association between this sign and cavernoma was recently recognized. On the other hand, in melanotic lesions, the relationship with T1WI-hyperintense perilesional edema has not yet been described. Despite being an infrequent sign, it can considerably narrow the differential diagnosis, which gives it a high value for clinical practice...
February 2016: Neuroradiology Journal
Leila Khoja, Catherine Maurice, MaryAnne Chappell, Leslie MacMillan, Ayman S Al-Habeeb, Nada Al-Faraidy, Marcus O Butler, Patrik Rogalla, Warren Mason, Anthony M Joshua, David Hogg
Anti-PD-1 inhibitors have significant activity in metastatic melanoma. Responses often occur early and may be sustained. The optimal duration of treatment with these agents is unknown. Here, we report the case of a 51-year-old woman treated with pembrolizumab, as part of the Keynote-001 trial, as first-line treatment for metastatic disease. She experienced a complete response after 13.8 months of treatment with no adverse events. One month after the last drug infusion and 18 months from starting treatment, the patient presented with eosinophilic fasciitis...
March 2016: Cancer Immunology Research
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