REVIEW PAPER
Primary cerebellopontine angle melanoma: Case Report and Systematic Review
 
More details
Hide details
1
Picapiedra Health Center, Peru
 
2
National Major San Marcos University, San Fernando Medical School, Lima, Peru
 
3
Chair and Department of Neurosurgery, Hospital Nacional Daniel Alcides Carrión, Callao, Peru
 
4
Chair and Department of Neurosurgery, National Major San Marcos University, Lima, Peru
 
 
Submission date: 2015-02-01
 
 
Acceptance date: 2016-04-07
 
 
Online publication date: 2016-05-05
 
 
Publication date: 2020-03-22
 
 
Corresponding author
Milton Jose Max Rodriguez-Zuniga   

1570 Prolongacion Iquitos, Apt. 905, Lince, Lima, Peru. Tel.: +51 950111539.
 
 
Pol. Ann. Med. 2017;24(2):268-275
 
KEYWORDS
ABSTRACT
Introduction:
Primary cerebellopontine angle melanoma (PCPAM) is one of the most rare primitive brain tumors. Its management and prognosis are drawn from very few published cases.

Aim:
The aim of this study was to provide an approach to help practitioners diagnosing similar cases.

Material and methods:
A systematic review was conducted. A PCPAM case is also presented.

Results:
The search yielded 13 cases of PCPAM (53% were males) with a median age of 32 years (range 26–56 years). The most frequent symptoms were hearing loss (77%) and ataxia (62%). All underwent neurosurgical removal of the tumor due to worsening of symptoms. Post-surgery follow-up showed that only half of the cases had free-of-disease survival beyond a year. The other half had a poor outcome few months after surgery. We present a 77-years-old female patient with PCPAM with clinical characteristics different from those described in the literature.

Discussion:
Results indicate that diagnosis criteria are still lacking specificity. Therefore, clinical features have led clinicians to reconsider the diagnosis more than once. New techniques, such as PET-scan and genetic analysis can greatly assist in the search for the primary tumor. owadays, complete resection and radiotherapy are still the gold standard treatment. Prognosis differs between the cases, but age and tumor biology are the main indicators of survival.

Conclusions:
We strongly suggest strengthening the surveillance of patients with PCPAM as the management and prognosis differ significantly from those with metastatic melanoma.

CONFLICT OF INTEREST
None declared.
 
REFERENCES (37)
1.
Liubinas SV, Maartens N, Drummond KJ. Primary melanocytic neoplasms of the central nervous system. J Clin Neurosci. 2010;17:1227–1232.
 
2.
Flanigan JC, Jilaveanu LB, Chiang VL, Kluger HM. Advances in therapy for melanoma brain metastases. Clin Dermatol. 2013;31:264–281.
 
3.
Moffat DA, Ballagh RH. Rare tumours of the cerebellopontine angle. Clin Oncol (R Coll Radiol). 1995;7:28–41.
 
4.
Walkden A, Shekhar H, Fouyas I, Gibson R. The diagnostic dilemma of cerebellopontine angle lesions: re-evaluating your diagnosis. BMJ Case Rep. 2013;2013.
 
5.
Bhandari L, Alapatt J, Govindan A, Sreekumar T. Primary cerebellopontine angle melanoma: a case report and review. Turk Neurosurg. 2012;22:469–474.
 
6.
Rodriguez y Baena R, Gaetani P, Danova M, Bosi F, Zappoli F. Primary solitary intracranial melanoma: case report and review of the literature. Surg Neurol. 1992;38:26–37.
 
7.
Wadasadawala T, Trivedi S, Gupta T, Epari S, Jalali R. The diagnostic dilemma of primary central nervous system melanoma. J Clin Neurosci. 2010;17:1014–1017.
 
8.
Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Intervention. The Cochrane Collaboration; 2011 http://www.cochrane-handbook.o....
 
9.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol. 2009;62:1006–1012.
 
10.
Brackmann DE, Doherty JK. CPA melanoma: diagnosis and management. Otol Neurotol. 2007;28:529–537.
 
11.
Oluigbo CO, Cooke SR, Flynn PA, Choudhari KA. Primary malignant melanoma of the cerebellopontine angle: a diagnostic dilemma: case report. Neurosurgery. 2006;59:E1336. discussion E1336.
 
12.
Piedra MP, Scheithauer BW, Driscoll CL, Link MJ. Primary melanocytic tumor of the cerebellopontine angle mimicking a vestibular schwannoma: case report. Neurosurgery. 2006;59:E206. discussion E206.
 
13.
Desai K, Dindorkar K, Goel A, Shenoy A. Primary cerebellopontine angle malignant melanoma: a case report. Neurol India. 2001;49:200–202.
 
14.
Vasdev A, David P, Villemot D, et al. Apparently primary malignant melanoma of the cerebellopontine angle. One case. J Neuroradiol. 1990;17:152–156.
 
15.
Kan P, Shelton C, Townsend J, Jensen R. Primary malignant cerebellopontine angle melanoma presenting as a presumed meningioma: case report and review of the literature. Skull Base. 2003;13:159–166.
 
16.
Whinney D, Kitchen N, Revesz T, Brookes G. Primary malignant melanoma of the cerebellopontine angle. Otol Neurotol. 2001;22:218–222.
 
17.
Braga FM, Tella Junior OI, Ferreira A, Jordy CF. Malignant melanoma of the cerebello-pontine angle region. Arq Neuropsiquiatr. 1989;47:496–500.
 
18.
Hussein MR. Extracutaneous malignant melanomas. Cancer Invest. 2008;26:516–534.
 
19.
Terao H, Yoshimatsu N, Sano K. [Intracranial melanoma]. No To Shinkei. 1968;20:991–999.
 
20.
Brat DJ, Giannini C, Scheithauer BW, Burger PC. Primary melanocytic neoplasms of the central nervous systems. Am J Surg Pathol. 1999;23:745–754.
 
21.
Block F. [Disorders of the cerebellopontine angle]. Radiologe. 2006;46:185–186. 188–191.
 
22.
Mallucci CL, Ward V, Carney AS, O'Donoghue GM, Robertson I. Clinical features and outcomes in patients with nonacoustic cerebellopontine angle tumours. J Neurol Neurosurg Psychiatry. 1999;66:768–771.
 
23.
Huang TW, Young YH. Differentiation between cerebellopontine angle tumors in cancer patients. Otol Neurotol. 2002;23:975–979.
 
24.
Swartz JD. Lesions of the cerebellopontine angle and internal auditory canal: diagnosis and differential diagnosis. Semin Ultrasound CT MR. 2004;25:332–352.
 
25.
Ragab A, Emara A, Shouker M, Ebied O. Prospective evaluation of the clinical profile and referral pattern differences of vestibular schwannomas and other cerebellopontine angle tumors. Otol Neurotol. 2012;33:863–870.
 
26.
Lange M, Duc LD, Horn P, Fink U, Oeckler R. Cerebellopontine angle meningiomas (cpam) – clinical characteristics and surgical results. Neurol Neurochir Pol. 2000;34:107–113.
 
27.
Jaiswal S, Vij M, Tungria A, Jaiswal AK, Srivastava AK, Behari S. Primary melanocytic tumors of the central nervous system: a neuroradiological and clinicopathological study of five cases and brief review of literature. Neurol India. 2011;59:413–419.
 
28.
Somers KE, Almast J, Biemiller RA, Silberstein HJ, Johnson MD, Mohile NA. Diagnosis of primary CNS melanoma with neuroimaging. J Clin Oncol. 2013;31:e9–e11.
 
29.
Hayward RD. Malignant melanoma and the central nervous system. A guide for classification based on the clinical findings. J Neurol Neurosurg Psychiatry. 1976;39:526–530.
 
30.
Tan JC, Chatterton BE. Is there an added clinical value of ‘‘true’’ whole body(18)F-FDG PET/CT imaging in patients with malignant melanoma? Hell J Nucl Med. 2012;15:202–205.
 
31.
Khan MK, Khan N, Almasan A, Macklis R. Future of radiation therapy for malignant melanoma in an era of newer, more effective biological agents. Onco Targets Ther. 2011;4:137–148.
 
32.
Greco Crasto S, Soffietti R, Bradac GB, Boldorini R. Primitive cerebral melanoma: case report and review of the literature. Surg Neurol. 2001;55:163–168. discussion 168.
 
33.
Cornejo KM, Hutchinson L, Cosar EF, et al. Is it a primary or metastatic melanocytic neoplasm of the central nervous system?: A molecular based approach. Pathol Int. 2013;63:559–564.
 
34.
Murali R, Wiesner T, Rosenblum MK, Bastian BC. GNAQ and GNA11 mutations in melanocytomas of the central nervous system. Acta Neuropathol. 2012;123:457–459.
 
35.
Gessi M, Hammes J, Lauriola L, et al. GNA11 and N-RAS mutations: alternatives for MAPK pathway activating GNAQ mutations in primary melanocytic tumours of the central nervous system. Neuropathol Appl Neurobiol. 2013;39:417–425.
 
36.
Kusters-Vandevelde HV, Klaasen A, Kusters B, et al. Activating mutations of the GNAQ gene: a frequent event in primary melanocytic neoplasms of the central nervous system. Acta Neuropathol. 2010;119:317–323.
 
37.
Narayan RK, Rosner MJ, Povlishock JT, Girevendulis A, Becker DP. Primary dural melanoma: a clinical and morphological study. Neurosurgery. 1981;9:710–717.
 
Journals System - logo
Scroll to top