Two Cases of Intracranial Metastatic Malignant Melanoma.

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Two cases of intracranial metastatic malignant melanoma are reported. Both patients were males of sixties with known primary skin malignant melanomas. Magnetic resonance imagings showed intracranial lesions, which were high intense in T1 WI, low intense in T2 WI and enhanced after Gd-DTPA adminisration. These findings were characteristic for intracranial malignat melanomas.Treatment design consisted of intra-arterial chemotherapy with CDDP and ACNU, follwed by surgical resection and/or radiosurgery. In the first case, intratumoral hemorrhage occurred 40 hours after the intra-arterial chemotherapy and emergent craniotomy, instead of radiosurgery, was performed. The second patient underwent tumor removal on the following day after the chemotherapy. Both patients died of systemic metastases 2 and 3 months after the treatment, respectively.Malignant melanomas are prone to metastasize to any organs including brain. Patients with malignant melanoma usually have short life expectancy, so the aim of treatment is focused on the maintenance of the QOL as long as possible. So, vigorous treatment should be carried out whenever necessary. Finally, spontaneous hemorrhage into intracranial malignant melanoma have been frequently observed. As shown in our case 1, treatment modalities might enhanced the risk of intratumoral hemorrhage. Care should be taken to avoid this serious complication
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