title: Pathologic complete response of a solitary melanoma brain metastasis after local ablative radiation therapy: case report.
abstract: A 73-year-old female with malignant melanoma metastatic to her left frontal lobe status post-gross total resection of the metastasis, whole brain radiotherapy, and Gamma Knife-based stereotactic radiosurgery for local recurrence presented with an area of increasing enhancement on follow-up magnetic resonance imaging (MRI) and hypermetabolic lesions on 18-fluorodeoxyglucose positron emission tomography/computerized tomography (18FDG PET/CT) of the brain suspicious for tumor recurrence. Surgical resection of the lesion was performed showing radiation necrosis with no evidence of tumor. The patient was alive 1 year after her second craniotomy. This case illustrates that despite being perceived as a radioresistant histology, complete local eradication of melanoma is possible with ablative dose regimens. Prolonged survival is possible in patients with limited metastatic melanoma if local tumor control is achieved.
authors.affiliation: Mount Carmel Health System, Columbus, OH 43210, USA. stevenregistermd@gmail.com
authors.forename: Steven
authors.initials: S
authors.lastname: Register
authors.forename: James W
authors.initials: JW
authors.lastname: Clarke
authors.forename: Abhik Ray
authors.initials: AR
authors.lastname: Chaudhury
authors.forename: Simon S
authors.initials: SS
authors.lastname: Lo
mesh_terms: D000368:Aged; D001932:Brain Neoplasms / Q000556:secondary / Q000628:therapy*; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008545:Melanoma / Q000473:pathology / Q000628:therapy*; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000628:therapy*; D049268:Positron-Emission Tomography; D011379:Prognosis; D016634:Radiosurgery; D014057:Tomography, X-Ray Computed