<% strPathPics = Session("strPathPicsL") imgBg = strPathPics + Session("strMedia") %> Metastatic Disease

Metastatic Melanoma - Case 2

A 52 year-old woman with a remote history of melanoma presented with the abrupt onset of a left hemiparesis and headaches.

Note the Blood on T1        Note the Blood on T2        Show the Vasogenic Edema       Show the Gadolinium Enhancement     

Metastatic Brain Tumor (Melanoma): Axial MRI images: (Left) T1-weighted; (Middle) T2-weighted; (Right) T1-weighted with gadolinium. Note the large mass in the right frontal lobe that enhances with gadolinium (right image). On the T1-weighted image (left image), note the bright signal within the mass. On the T2-weighted image (middle image), there is a dark rim surrounding a dark signal. This is the MRI picture of subacute blood (intracellular methemoglobin). Melanoma is one of the metastatic tumors that commonly bleeds.

Metastatic disease from primary tumors elsewhere in the body account for approximately 50% of all brain tumors. Metastases to the brain are nearly always via the blood stream. They are typically found at the junctions between the gray and white matter, which are highly vascular. Metastatic lesions commonly present with focal or focal to generalized seizures or slowly progressive neurological deficits. When the lesions become very large, signs and symptoms of increased intracranial pressure develop (i.e., headache, lethargy, nausea and vomiting). The most common primary tumors that metastasize to the brain are lung and breast. Other tumors may also spread to the brain, including melanoma, lymphoma, GI, and GU cancers. In some cases, it is the metastatic lesion in the brain, and not the primary tumor, that brings the patient to medical attention.


Revised 11/29/06.
Copyrighted 2006. David C Preston