Pathologic complete response of a solitary melanoma brain metastasis after local ablative radiation therapy: case report

Med Oncol. 2010 Dec;27(4):1208-11. doi: 10.1007/s12032-009-9360-3. Epub 2009 Nov 18.

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.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Brain Neoplasms / secondary
  • Brain Neoplasms / therapy*
  • Combined Modality Therapy
  • Cranial Irradiation*
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Melanoma / pathology
  • Melanoma / therapy*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / therapy*
  • Positron-Emission Tomography
  • Prognosis
  • Radiosurgery*
  • Tomography, X-Ray Computed