Joonho Byun 1, Eun Suk Park 2, Seok Ho Hong 1, Young Hyun Cho 1, Young-Hoon Kim 1, Chang Jin Kim 1, Jeong Hoon Kim 3, Seungjoo Lee 4
Abstract
Objectives: Primary intracranial malignant melanoma (PIMM) is extremely rare central nervous system (CNS) tumor and known for only composed 0.07% of the CNS tumors. PIMM composed only 1% of malignant melanoma and accordingly their clinical behavior and prognosis are not well documented. So, herein, we report our experience of pathologically proven PIMM, and compared their clinical characteristics and outcome with metastatic intracranial malignant melanoma (MIMM).
Patients and methods: Our institutional database was reviewed for patients who diagnosed as PIMM and MIMM pathologically between 1996-2016. As a result, a total of 6 patients of PIMM and 18 patients of MIMM were identified and analyzed. All these patients' clinical, radiological, histopathological and surgical records were obtained and reviewed.
Results: The median age of PIMM patients at initial surgery was 54.5 years (range, 30-60 years). During the mean follow-up of 12.8 months (range: 9-21 months), tumor recurrence occurred in 5 patients (83.3%). The overall survival rates of PIMM at 6, 9, 12 and 18 months were 100%, 83%, 50% and 25%. The PFS rates of PIMM at 3,6,9 and 12 months were 66.7%, 50%, 16.7% and 16.7%. The overall survival rates and progression-free survival rate difference between PIMM and MIMM were not statistically significant. (p=0.723 and p=0.6, respectively).
Conclusion: According to our experience, PIMM is very aggressive malignant tumor. Its median survival was less than 1year. We suggest that maximal safe resection plus adjuvant RT and CTX for intracranial malignant melanoma considering highly aggressive clinical course of this tumors.
Keywords: Metastatic intracranial malignant melanoma; Primary intracranial malignant melanoma.
Fig. 4. Survival curve of primary intracranial melanoma (PIMM) and metastatic intracranial melanoma
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