Vascular white matter lesions negatively correlate with brain metastases in malignant melanoma-Results from a...

Brain metastasis (BM) is a major complication of different cancers. There is increasing evidence for influence of vascular factors on BM in patients with non-small cell lung cancer (NSCLC). It is not known if the same is true for other tumors that might rely on different forms of vasculogenesis. The objective of this retrospective study was to evaluate a possible negative association of vascular white matter lesions and vascular risk factors (vasRF) with brain metastases in patients with melanoma.

3D-brain magnetic resonance imaging (MRI) of 30 patients with BM from malignant melanoma and screening MRI of 31 BM negative patients were analysed. Number of metastases was calculated and T2 hyperintensive white matter lesions (WML) were classified according to Fazekas-Score (grade I-III) per patient and compared between BM+ and BM- patients.

Patients without BM showed more pronounced WML (median = WML 1, mean = 1.3; SD = 1.04,) than patients with BM (median = WML 0, mean = 0.6; SD = 0.8, p = 0.017). With respect to vascular risk factors, BM were more likely (p^x2 = 0.019) in patients without vasRF.

WML and possibly vasRF may reduce the risk of BM in different malignant tumors including melanoma. Presence of WML in patients with BM could potentially influence treatment choice regarding local or whole brain treatment after further multicentric prospective validation.