title: Multiple cutaneous melanomas associated with gastric and brain metastases.
abstract: The occurrence of multiple primary melanomas in a single individual is rare. Most commonly, malignant melanocytic lesions subsequent to the initial diagnosis of melanoma are secondary cutaneous metastases. We report a patient with gastrointestinal bleeding from gastric metastasis of cutaneous melanoma. During clinical evaluation and staging, we discovered a brain metastasis associated with 3 synchronous primary cutaneous melanomas. We suggest the research on the mutation in the cyclin-dependent kinase inhibitor 2A (CDKN2A) (INK4a) in such cases. We also emphasize the importance of clinical examination and dermoscopy of the entire tegument, even after a malignant melanocytic lesion is identified.
authors.affiliation: Universidade do Estado do Rio de Janeiro (UERJ) - Rio de Janeiro (RJ), Brazil.
authors.forename: Lara Caroline
authors.initials: LC
authors.lastname: Grander
authors.affiliation: Universidade do Estado do Rio de Janeiro (UERJ) - Rio de Janeiro (RJ), Brazil.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Cabral
authors.affiliation: Private clinic - São Paulo (SP) - Brazil.
authors.forename: Alice Paixão
authors.initials: AP
authors.lastname: Lisboa
authors.affiliation: Private clinic - Rio de Janeiro (RJ), Brazil.
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Vale
authors.affiliation: Universidade do Estado do Rio de Janeiro (UERJ) - Rio de Janeiro (RJ), Brazil.
authors.forename: Carlos Baptista
authors.initials: CB
authors.lastname: Barcaui
authors.affiliation: Universidade do Estado do Rio de Janeiro (UERJ) - Rio de Janeiro (RJ), Brazil.|Universidade Federal do Rio de Janeiro (UFRJ) - Rio de Janeiro (RJ), Brazil.
authors.forename: Juan Manuel Pineiro
authors.initials: JM
authors.lastname: Maceira
mesh_terms: D000368:Aged; D001706:Biopsy; D001932:Brain Neoplasms / Q000235:genetics / Q000556:secondary*; D019941:Cyclin-Dependent Kinase Inhibitor p16; D050763:Cyclin-Dependent Kinase Inhibitor p18 / Q000235:genetics; D046169:Dermoscopy; D006801:Humans; D008545:Melanoma / Q000235:genetics / Q000556:secondary*; D009154:Mutation; D009378:Neoplasms, Multiple Primary / Q000235:genetics / Q000473:pathology*; D012878:Skin Neoplasms / Q000235:genetics / Q000473:pathology*; D013274:Stomach Neoplasms / Q000235:genetics / Q000556:secondary*
chemical_list: C000614131:CDKN2A protein, human; D019941:Cyclin-Dependent Kinase Inhibitor p16; D050763:Cyclin-Dependent Kinase Inhibitor p18