Primary Pineal Region Melanoma: Case Report and Review of the Literature

We report here the 20th case of primary pineal tumor and the third case that was totally removed among these 20 cases. Our case was of a 62-year-old man who had headache, dizziness, gait disorder, and the signs and symptoms of ICP arising because of hydrocephalus-like vomiting for 4 weeks before admission. His images showed a hyperdense mass plus hydrocephalus in computed tomographic scan, a hyperintense solid mass in MRI-T1, and hypointense mass lesionin MRI-T2 and FLAIR that significantly enhances the lesion after gadolinium administration in the pineal region. We operated him through the supracerebellar-infratentorial approach and we totally resected this solid mass by microsurgery. The tumor was interestingly black in color, and when the pathologist reported it as melanoma, we consulted with an ophthalmologist and a dermatologist for further evaluation of the patient to find any source of melanoma in his body. However, they could not find any site other than the brain for the same. The patient was discharged 3 days after the surgery without any neurological deficit and in full recovery. We did not send the patient for chemotherapy or radiotherapy, and after 6 months (24 wk) of discharge he had no complaint and resumed work without any problem. Here, we tried to review the previously reported cases in the literature and meticulously present our case. Obviously, using adjuvant therapy is a controversial issue in this rare tumor, but we believe that total microsurgical resec...
Source: Neurosurgery Quarterly - Category: Neurosurgery Tags: Case Reports Source Type: research