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Metastatic melanoma to the cerebellopontine angle. Clinical and imaging characteristics
M A Arriaga1, W W Lo, D E Brackmann
1Department of Otolaryngology, Wilford Hall Air Force Medical Center, Lackland Air Force Base, Tex, USA.
Objective:
To describe the clinical and imaging features of metastatic melanoma to the cerebellopontine angle (CPA).
Design:
A case series study with world literature review.
Setting:
House Ear Clinic and St Vincent's Hospital, Los Angeles, Calif.
Patients:
Three cases of metastatic CPA tumors operated on at the House Ear Clinic.
Interventions:
All patients underwent surgical removal of CPA metastatic melanoma.
Main Outcome Measure:
Survival and duration of disease-free interval are reported.
Results:
Two patients died of melanoma within 5 months of diagnosis and resection of CPA melanoma metastases. One patient survived for 5 years after undergoing total resection of an isolated CPA melanoma metastasis. Magnetic resonance imaging features were not uniform.
Conclusions:
Metastatic melanoma to the CPA should be suspected in patients with a history of melanoma and a rapid progression of audiovestibular or facial nerve symptoms. Surgical removal of solitary metastases to the CPA may be valuable in patients without other melanoma focus; however, the long-term prognosis for patients with CPA melanoma is grim.
