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Primary central nervous system amelanotic melanoma in a Hispanic male: Case report

Sarmad Said, Haider Alkhateeb, Chad J. Cooper, Juan M. Galvis, Hongfei Fang, German T. Hernandez, Hasan J. Salameh

(Department of Internal Medicine, Texas Tech University Health Science Center, Paul L. Foster School of Medicine, El Paso, USA)

Pol J Radiol 2014; 79:199-202

DOI: 10.12659/PJR.890733

Background: Primary melanotic neoplasms of the central nervous system (CNS) are uncommon; amelanotic melanomas in this region are extremely rare. Very few cases of amelanotic variation of primary melanoma in the CNS were reported on. General guidelines or recommendations to establish this diagnosis do not exist.
Case Report: A sixty-year-old male Hispanic patient presented with a 7-day history of numbness and dizziness. Initial laboratory work-up and physical examination were inconclusive. Cerebral radiological imaging showed a left frontal lesion. Further work-up after clinical deterioration revealed an increase in the lesion size consistent with hemorrhage and changes in T1WI. Biopsy and immunochemistry demonstrated the presence of amelanotic melanoma in the CNS without evidence of another primary lesion.
Conclusions: Primary amelanotic melanoma of the CNS represents a challenge, clinically and diagnostically. Magnetic resonance imaging can be helpful in early stages. Final diagnosis is established with immunohistochemical testing. Physicians should be aware of the existence of this rare manifestation and difficulties faced while building this diagnosis.

Keywords: Magnetic Resonance Angiography, Melanoma, Amelanotic, Tumor Markers, Biological

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
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