title: Leptomeningeal metastases from a primary central nervous system melanoma: a case report and literature review.
abstract: Primary central nervous system (CNS) melanoma is a type of rare and aggressive tumor that can easily spread to the leptomeninges, and in fact, leptomeningeal metastasis is one of the most serious complications in patients with this carcinoma. Prognosis is extremely poor if a CNS melanoma has metastasized, and there are no effective treatments. Here, we present a case of a 37-year-old woman who presented with horizontal diplopia and progressive headache. Magnetic resonance imaging findings were consistent with the diagnosis of melanoma. The results of cytological examination of cerebrospinal fluid (CSF) showed malignant cells characteristic of melanoma. No extracranial lesions were observed. All of the available evidence confirmed a diagnosis of leptomeningeal metastases from a primary CNS melanoma. The patient received aggressive treatment, which consisted of concurrent radiotherapy and weekly intra-CSF methotrexate (MTX) followed by adjuvant monthly intra-CSF MTX. Her survival time was 13 months after diagnosis. This case report suggests that the modality of concurrent radiotherapy and weekly intra-CSF MTX followed by adjuvant monthly intra-CSF MTX may be used as the mainstay of treatment for such patients.
authors.forename: Zhenyu
authors.initials: Z
authors.lastname: Pan
authors.forename: Guozi
authors.initials: G
authors.lastname: Yang
authors.forename: Yongxiang
authors.initials: Y
authors.lastname: Wang
authors.forename: Tingting
authors.initials: T
authors.lastname: Yuan
authors.forename: Yan
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Radiotherapy, Norman Bethune First Hospital, Jilin University, 71 Xinmin Street, Changchun 130021, China. drlhdong@163.com.
authors.forename: Lihua
authors.initials: L
authors.lastname: Dong
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000134:cerebrospinal fluid / Q000473:pathology* / Q000601:surgery; D059248:Chemoradiotherapy; D005260:Female; D006801:Humans; D008545:Melanoma / Q000134:cerebrospinal fluid / Q000473:pathology* / Q000601:surgery; D008577:Meningeal Neoplasms / Q000134:cerebrospinal fluid / Q000556:secondary* / Q000628:therapy; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D014057:Tomography, X-Ray Computed
chemical_list: D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate