Dural-Based Metastatic Malignant Melanoma Masquerading as Meningiomata: A Diagnostic Challenge
Despite both clinical and radiographic examination, metastases from malignant melanomas can be susceptible to misdiagnoses, particularly when they are found in uncommon locations. We report on an unsettling case of a 38-year-old woman who presented to neurosurgery with worsening neurological symptoms. Upon magnetic resonance imaging, the patient was found to have two sizeable dural-based lesions and underwent subsequent resection of the larger mass. Although the results of the pathohistological examination and immunohistochemistry staining were suspicious for metastatic malignant melanoma, an incorrect diagnosis of atypical meningioma was rendered due to the patient’s age and lack of melanoma history. After the patient’s condition continued to clinically deteriorate, dermatology was ultimately consulted and a more comprehensive work-up was carried out, revealing the correct and exceedingly rare diagnosis of dural-based metastatic melanoma of unknown primary. This case underscores the importance of an interdisciplinary diagnostic approach; one which employs comprehensive histopathologic evaluation, judiciously selected immunohistochemical staining, and thorough physical examination.
Barajas RF Jr, Cha S. Metastasis in Adult Brain Tumors. Neuroimaging Clin N Am. 2016;26(4):601–620. doi:10.1016/j.nic.2016.06.008
Nayak L, Abrey LE, Iwamoto FM. Intracranial dural metastases. Cancer. 2009;115:1947–1953.
Savage NM, Alleyne CH, Vender JR, et al. Dural-based metastatic carcinomas mimicking primary CNS neoplasia: report of 7 cases emphasizing the role of timely surgery and accurate pathologic evaluation. Int J Clin Exp Pathol. 2011;4(5):530–540.
Scherer K, Johnston J, Panda M. Dural based mass: malignant or benign. J Radiol Case Rep. 2009;3(11):1–12. doi:10.3941/jrcr.v3i11.189
Abstract - 116 PDF - 20
- There are currently no refbacks.