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Case Report
Available online 3 March 2022
Primary intracranial melanoma, amelanotic variant: Case report
Variante amelanótica en melanoma cerebral primario: a propósito de un caso
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Julio Alberto Andrés Sanza,b,
Corresponding author
, Juan Antonio Ruiz Ginésa,b, Hristo Ilievc, Jesús Aguas Valientea,b
a Servicio de Neurocirugía, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
b Instituto de investigación Sanitaria de Aragón (IISA), Spain
c Servicio de Anatomía Patológica, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
Received 12 June 2021. Accepted 24 August 2021
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Abstract

Primary brain melanoma is a very rare tumour (only 0.07% of primary CNS neoplasms) which usually shows with abundant melanin content; whereas hypo/melanotic variants have been scarcely described.

We introduce the case of a female patient with headache, left brachial paresis and frontallobar syndrome. The MRI image showed a right frontal mass with homogeneous contrast uptake. As treatment, a complete surgical resection was performed. Pathology was diagnostic for melanoma, with very low melanin content and a high proliferative index. A thorough extension study was performed to rule out an extracranial primary origin. Due to several intercurrent complications, the patient evolved unfavorably, not being able to receive further treatment.

The amelanotic variant of primary intracranial malignant melanomas has not been described in detail previously. We will review the literature, focusing on the particularities of management and diagnosis of this clinical entity.

Keywords:
Melanoma
Brain tumor
Amelanotic
Abdominal hematoma
Neurooncology
Resumen

El melanoma cerebral primario es un tumor muy infrecuente (0,07% de las neoplasias primarias del SNC). Generalmente muestra un abundante contenido en melanina, y sólo en 7 ocasiones se han descrito variantes hipo/amelanóticas.

Presentamos el caso de una paciente con clínica de cefalea, paresia braquial izquierda y síndrome lobar frontal. La RM mostró una masa frontal derecha con captación homogénea de contraste. Como tratamiento, se realizó una resección quirúrgica completa. El estudio anatomopatológico fue diagnóstico para melanoma, con muy escaso contenido en melanina y alto índice proliferativo. Se realizó un estudio de extensión exhaustivo para descartar otra localización primaria. Debido a varias complicaciones intercurrentes, la paciente evolucionó desfavorablemente, sin llegar a recibir otros tratamientos.

La variante amelanótica de los melanomas cerebrales primarios no ha sido descrita con detalle previamente. Repasaremo la literatura al respecto y discutimos los detalles de manejo y diagnóstico de esta entidad clínica.

Palabras clave:
Melanoma
Tumor cerebral
Amelanótico
Hematoma abdominal
Neurooncología

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