title: Solitary cerebral metastasis from melanoma: value of the 'en bloc' resection.
abstract: The authors report 19 cases of solitary cerebral metastases from malignant melanoma. In 15 patients, the primary lesion was known at the time the metastasis was diagnosed; deltoid-scapular in 4 cases, thoracic in 5, inguinal in 4 and neck in 2. The primary location was unknown in 4 patients. Presenting symptoms were: epileptic seizures in 9 cases, headache in 8, strength deficit of the limbs in 2. In 3 patients (16%) neurological symptoms were the first clinical sign of the systemic tumor; in 16 cases (84%) there was a long interval between treatment of the primary and appearance of the cerebral metastasis (average 3.8 years; median 3.4 years). All patients were submitted to surgery and radiotherapy (whole-brain in 14 and radiosurgery in 5). In 10 cases the lesion was removed 'en bloc' (no internal touch technique). Average survival was 9 months (median 8 months) and was influenced by 'en bloc' resection and whole-brain irradiation. None of the patients operated by the 'no touch technique' presented a recurrence.
authors.affiliation: Mediterranean Sanatrix Institute of Neurosciences, IRCCS, Pozzilli (Is), Italy.
authors.forename: M
authors.initials: M
authors.lastname: Salvati
authors.forename: L
authors.initials: L
authors.lastname: Cervoni
authors.forename: R
authors.initials: R
authors.lastname: Caruso
authors.forename: F M
authors.initials: FM
authors.lastname: Gagliardi
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery*; D003388:Cranial Fossa, Posterior / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local