Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2022; 10(30): 11162-11171
Published online Oct 26, 2022. doi: 10.12998/wjcc.v10.i30.11162
Longest survival with primary intracranial malignant melanoma: A case report and literature review
Tang-Fai Wong, Yin-Sheng Chen, Xiang-Heng Zhang, Wan-Ming Hu, Xiao-Shi Zhang, Yan-Chun Lv, Dong-Cun Huang, Mei-Ling Deng, Zhong-Ping Chen
Tang-Fai Wong, Department of Neurosurgery, Macao Kiang Wu Hospital, Macao 999078, Sichuan Province, China
Tang-Fai Wong, Yin-Sheng Chen, Xiang-Heng Zhang, Zhong-Ping Chen, Department of Neurosurgery/Neuro-Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
Wan-Ming Hu, Department of Pathology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
Xiao-Shi Zhang, Department of Biotherapy, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
Yan-Chun Lv, Dong-Cun Huang, Department of Medical Imaging, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, Guangdong Province, China
Mei-Ling Deng, Department of Radiotherapy, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
Author contributions: Chen YS, Hu WM, Lv YC, Huang DC, and Deng ML designed and performed the research content; Wong TF, Zhang XH, and Chen ZP wrote the paper; all authors wrote, read, and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this case report and any accompanying images.
Conflict-of-interest statement: All authors declare no direct conflict of interest for this work.
CARE Checklist (2016) statement: All authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhong-Ping Chen, MD, PhD, Chief Doctor, Neurosurgeon, Professor, Department of Neurosurgery/Neuro-Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, No. 651 Dongfeng East Road, Yuexiu District, Guangzhou 510060, Guangdong Province, China. chenzhp@sysucc.org.cn
Received: July 2, 2022
Peer-review started: July 2, 2022
First decision: August 1, 2022
Revised: August 10, 2022
Accepted: September 7, 2022
Article in press: September 7, 2022
Published online: October 26, 2022
Processing time: 110 Days and 20.9 Hours
Abstract
BACKGROUND

Primary intracranial malignant melanoma (PIMM) is rare, and its prognosis is very poor. It is not clear what systematic treatment strategy can achieve long-term survival. This case study attempted to identify the optimal strategy for long-term survival outcomes by reviewing the PIMM patient with the longest survival following comprehensive treatment and by reviewing the related literature.

CASE SUMMARY

The patient is a 47-year-old Chinese man who suffered from dizziness and gait disturbance. He underwent surgery for right cerebellum melanoma and was subsequently diagnosed by pathology in June 2000. After the surgery, the patient received three cycles of chemotherapy but relapsed locally within 4 mo. Following the second surgery for total tumor resection, the patient received an injection of Newcastle disease virus-modified tumor vaccine, interferon, and β-elemene treatment. The patient was tumor-free with a normal life for 21 years before the onset of the recurrence of melanoma without any symptoms in July 2021. A third gross-total resection with adjuvant radiotherapy and temozolomide therapy was performed. Brain magnetic resonance imaging showed no residual tumor or recurrence 3 mo after the 3rd operation, and the patient recovered well without neurological dysfunction until the last follow-up in June 2022, which was 22 years following the initial treatment.

CONCLUSION

It is important for patients with PIMM to receive comprehensive treatment to enable the application of the most appropriate treatment strategies. Long-term survival is not impossible in patients with these malignancies.

Keywords: Primary intracranial malignant melanoma; Immunotherapy; Newcastle disease virus-modified tumor vaccine; β-elemene; Long-term survival; Case report

Core Tip: Primary intracranial malignant melanoma (PIMM) is quite rare, and its prognosis is poor. Comprehensive treatment, including the surgical resection and the maintenance of postoperative adjuvant treatments by Newcastle disease virus-modified tumor vaccine, interferon, and β-elemene may prolong patient survival. We hope that the PIMM case reported in this paper, which describes a patient whose life was extended by 22 years, can provide useful information for the reference of medical practitioners and patients alike, thereby boosting their confidence in adopting the treatment reported herein.