title: Melanoma leptomeningeal dissemination following frontoparietal metastasis surgery: Case report and review of the literature.
abstract: We present the case of a patient with a solitary left frontoparietal brain metastasis of melanoma previously treated with surgery. Three months later, the patient was admitted to the emergency room in a confusional state with meningeal signs. A cerebrospinal fluid (CSF) test and magnetic resonance imaging findings suggested a subarachnoid haemorrhage (SAH) and/or meningeal carcinomatosis. The results of a cytological examination of the CSF showed neoplastic epithelial cells consistent with metastatic melanoma cells. Resection of metastatic posterior fossa lesions is often cited as a risk factor for leptomeningeal dissemination, however, when the resection is limited to the anterior fossa, this complication is relatively rare. In contrast, SAH may be a complication of leptomeningeal dissemination and responsible for acute meningeal syndrome. Treatment with high doses of corticoids did not show any improvement, and intrathecal chemotherapy was not possible due to the patient's poor functional status. She succumbed 1 week after admission.
authors.affiliation: Department of Medical Oncology, Infanta Sofía Hospital, San Sebastián de los Reyes, Madrid, Spain.
authors.forename: María Sereno
authors.initials: MS
authors.lastname: Moyano
authors.forename: Gerardo
authors.initials: G
authors.lastname: Gutiérrez-Gutiérrez
authors.forename: Isabel
authors.initials: I
authors.lastname: Rodríguez-Esteban
authors.forename: Gemma Sánchez
authors.initials: GS
authors.lastname: Crespo
authors.forename: Enrique
authors.initials: E
authors.lastname: Casado