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Journal Information
Vol. 7. Issue 4.
Pages 275-280 (January 1996)
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Vol. 7. Issue 4.
Pages 275-280 (January 1996)
Metástasis cerebrales de melanoma
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M. Clavel Escribano, P. Clavel Laria
Neurocirugía, Clínica del Pilar, Barcelona
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Resumen

La incidencia de metástasis cerebral de melanoma maligno cutáneo se ha incrementado de forma alarmante en los últimos años, siendo la tercera metástasis más frecuente después de la de pulmón y mama.

Aunque la enfermedad tiene un mal pronóstico existen casos publicados en la bibliografía de pacientes con largas supervivencias. Esta es la situación en el primero de los pacientes presentados por nosotros en este trabajo, quien tras ser sometido a tres craneotomías, se encuentra asintomático transcurridos más de 4 años desde la primera resección quirúrgica. Presentamos otros dos pacientes, uno con evolución fulminante y otro con un curso clínico más indolente.

Se realiza una revisión de la bibliografía con recomendaciones sobre la conveniencia de la cirugía en estos pacientes. Se revisa la aplicación de la radioterapia y la reciente aportación de la radiocirugía.

Palabras clave:
Tumor cerebral
Metástasis
Melanoma
Cirugía
Radioterapia
Radiocirugía
Summary

The incidence of metastatic malignant melanoma has experienced an important increase in the last years, becoming the third most frequent origin of cerehral metastases.

Although the disease has a poor prognosis, a few cases associated to long term survival, have been reported. We present one patient who underwent three craniotomies for resection of metastases from melanoma. More than four years after the first surgical procedure he is active and asymptomatic. Our second case suffered a fulminant course and the third a much more indolent clinical course.

A revision of the literature is made, and the criteria to be followed concerning surgical indications are considered. We also review the benefits of whole brain radiotherapy added to the surgical therapy and the recent application of the stereotactic radiosurgery.

Key words:
Brain tumor
Metastases
Melanoma
Surgery
Radiotherapy
Stereotactic radiosurgery

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