Clinical features of primary central nervous system malignant melanoma

doi:10.3969/j.issn.1006-7795.2023.02.023

Abstract

Abstract: Objective To summarize the clinical, imaging, therapeutic and prognostic features of primary central nervous system (CNS) malignant melanoma(MM). Methods The clinical data of 17 patients with primary CNS MM admitted to the Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, during 2011-2021 were divided into four clinical types for retrospective analysis. Results The male to female ratio was 11∶6, and the mean age was (39.9±16.6) years. Among them, 6 cases were type A, 5 type B, 4 type C, and 2 type D. There were 11 cases of cranial hypertension, 9 cases of local nerve dysfunction and 3 cases of epilepsy. High T1 signal was observed in 12 cases on magnetic resonance imaging（MRI） scan. There were 13 cases had seeding metastasis, 11 of which were linear. The fourteen cases underwent surgical resection, 3 cases underwent biopsy, and 6 cases underwent anti-tumor therapy after surgery. Overall, the median overall survival (mOS) was 7 months, and the survival of patients with combined treatment was significantly longer than that with surgery alone ［(20.6±7.9) months vs (3.3±0.9) months, P=0.001］. There were significant differences in symptoms, imaging, and treatment among the 4 clinical types. Conclusion The incidence of primary CNS malignant melanoma is low, and most of them have obvious imaging features, which can be divided into four clinical types. The disease requires surgery combined with radiotherapy and other comprehensive treatment, yet now the prognosis is stile poor.

Key words: central nervous system, malignant melanoma, clinical types, diagnosis, treatment

CLC Number:

R739.4

Wang Haoran, Gu Chunyu, Qu Yanming, Liu Ning, Ning Weihai, Ji Junpeng, Zhang Mingshan. Clinical features of primary central nervous system malignant melanoma[J]. Journal of Capital Medical University, 2023, 44(2): 335-342.

0
/ / Recommend

Add to citation manager EndNote|Reference Manager|ProCite|BibTeX|RefWorks

URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2023.02.023

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2023/V44/I2/335

References

［1］Wang J, Guo Z Z, Wang Y J, et al. Microsurgery for the treatment of primary malignant intracranial melanoma: a surgical series and literature review［J］. Eur J Surg Oncol, 2014, 40(9):1062－1071.
［2］Man W T, Wang G H. Incidence, outcomes and predictors of primary central nervous system melanoma: A SEER-based study［J］. World Neurosurg, 2019, 129: e782-e790.
［3］Zunarelli E, Bettelli S, Reggiani-Bonetti L, et al. Cerebrospinal fluid cytology in a case of primary diffuse leptomeningeal and pineal melanocytic lesion, with histological confirmation［J］. Pathology, 2010, 42(3):292－295.
［4］陈利锋, 韩丽娜, 刘嘉霖, 等. 中枢神经系统原发恶性黑色素瘤临床分析［J］. 临床神经外科杂志, 2020, 17(5):528－532.
［5］乔宇. 颅内原发性恶性黑色素瘤的诊治进展［J］. 医学研究生学报, 2016, 29(1):97－99.
［6］Zhou M G, Wang H D, Zeng X Y, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990－2017: a systematic analysis for the Global Burden of Disease Study 2017［J］. Lancet, 2019, 394(10204):1145－1158.
［7］Virchow R. Pigment und diffuse melanose der arachnoides［J］. Archiv für pathologische Anatomie und Physiologie und für klinische Medicin, 1859, 16(1):180－182.
［8］Offiah C J, Laitt R D. Case report: Intracranial meningeal melanocytoma: a cause of high signal on T1- and low signal on T2-weighted MRI［J］. Clin Radiol, 2006, 61(3):294－298.
［9］Wendel C, Kaech D L, Woodtli M. Primary malignant melanoma in the pineal region: case report and literature review［J］. J Neurol Surg A Cent Eur Neurosurg, 2018, 79(4):344－352.
［10］Isiklar I, Leeds N E, Fuller G N, et al. Intracranial metastatic melanoma: correlation between MR imaging characteristics and melanin content［J］. AJR Am J Roentgenol, 1995, 165(6):1503－1512.
［11］Willis R A. The hamartomatous syndromes: their clinical, pathological and fundamental aspects［J］. Med J Aust, 1965, 1(23):827－833.
［12］Hayward R D. Malignant melanoma and the central nervous system. A guide for classification based on the clinical findings［J］. J Neurol Neurosurg Psychiatry, 1976, 39(6):526－530.
［13］中国临床肿瘤学会指南工作委员会. 中国临床肿瘤学会(CSCO)黑色素瘤诊疗指南: 2021［M］. 北京: 人民卫生出版社, 2021.
［14］Mao L L, Ding Y, Bai X, et al. Overall survival of patients with unresectable or metastatic BRAF V600-mutant acral/cutaneous melanoma administered dabrafenib plus trametinib: long-term follow-up of a multicenter, single-arm phase Ⅱa trial［J］. Front Oncol, 2021, 11: 720044.
［15］董永, 孙季萍, 楼芳. 恶性黑色素瘤脑转移的综合治疗进展［J］. 临床肿瘤学杂志, 2019, 24(10):948－953.
［16］Long G V, Atkinson V, Lo S, et al. Combination nivolumab and ipilimumab or nivolumab alone in melanoma brain metastases: a multicentre randomised phase 2 study［J］. Lancet Oncol, 2018, 19(5):672－681.

[1]	Liu Xiu, Li Wencai. Preliminary study on the effect of UNC0379 on the proliferation of glioma cells [J]. Journal of Capital Medical University, 2023, 44(5): 741-746.
[2]	Peng Yichen, Zheng Yi, Li Shenglan, Yu Jianyu, Lan Yanjie, Liu Xinrui, Chen Feng, Li Wenbin. Study of genes associated with aberrant methylation regulation in high-grade meningiomas [J]. Journal of Capital Medical University, 2023, 44(5): 747-752.
[3]	Yin Shuo, Chen Feng, Zheng Xiaohong, Zhang Weichunbai, Li Wenbin. Novel drug therapies promote the treatment progress of primary central nervous system lymphoma [J]. Journal of Capital Medical University, 2023, 44(5): 775-781.
[4]	Zhang Shu, Wang Kai, Yang Zihao, Qiao Zhen, Li Xiaotong, Yuan Leilei, Ai Lin. Application of ¹¹C-MET PET/CT in screening isocitric dehydrogenase and 1p/19q status in supratentorial lower-grade gliomas [J]. Journal of Capital Medical University, 2022, 43(6): 826-833.
[5]	Xu Yang, Wang Kai, Chen Qiang, Ai Lin. Advances about molecular imaging of nuclear medicine in diagnosis and treatment of glioma [J]. Journal of Capital Medical University, 2022, 43(6): 880-885.
[6]	Li Chenchen, Xu Junmei, He Qianqian, Li Jiaying, Li Zhiheng, Xu Zhiqing, Yang Yutao. Phloretin inhibits oxidative stress response in LPS-stimulated BV2 microglia [J]. Journal of Capital Medical University, 2022, 43(1): 99-105.
[7]	Zhao Xiaoxiao, Yu Qiuhong, Ji Jianghuai, Wang Shijia, Wang Rendong, Li Dongguo. Identification of protein-coding genes regulated by differential DNA methylation enhancer regions in glioblastoma [J]. Journal of Capital Medical University, 2022, 43(1): 113-119.
[8]	Wang Wei, Lu Xia, Liu Jun, Kan Ying, Liu Jie, Yang Jigang. The value of ¹²³I-MIBG SPECT/CT tomography imaging in Curie score of pediatric neuroblastoma [J]. Journal of Capital Medical University, 2021, 42(1): 8-14.
[9]	Sun Mengxue, Wang Leiming, Teng Lianghong. Research progress on BRAF gene abnormality in glioma [J]. Journal of Capital Medical University, 2020, 41(3): 380-384.
[10]	Chen Feng, Zheng Xiaohong, Li Wenbin. Immunotherapy for the treatment of glioma [J]. Journal of Capital Medical University, 2019, 40(6): 966-971.
[11]	Yu Chunna, Jiang Bo, Li Wenbin, Chen Feng. Effects of β-hydroxybutyrate on the proliferation and glycolysis in glioma cells [J]. Journal of Capital Medical University, 2019, 40(2): 186-190.
[12]	Ma Xiangke, Yang Yang. Endovascular treatment of intracranial aneurysms: angiographic features and treatment outcome [J]. Journal of Capital Medical University, 2018, 39(6): 950-954.
[13]	Zhang Chuanbao, Jiang Tao. The Second Grade National Prize for Science and Technology Progress——the innovation and application of key technologies in the diagnosis and treatment of brain glioma [J]. Journal of Capital Medical University, 2018, 39(1): 1-5.
[14]	Zhang Wenli, Kong Fanhong, He Lu, Dong Chengya, Wang Yajie. Evaluation of biological characteristics of two u87 glioma cell lines after STR typing technique [J]. Journal of Capital Medical University, 2018, 39(1): 74-78.
[15]	Xia Pengfei, Wang Wei, Zou Liang, Ma Yingming. Efficacy and safety of modified antiplatelet preparation in patients with high on-treatment platelet reactivity after endovascular coiling for unruptured intracranial aneurysms [J]. Journal of Capital Medical University, 2018, 39(1): 143-147.