Primary pineal melanoma with long-term survival: case report

Area of Science:

• Neuro-oncology
• Melanoma Research
• Neurosurgery

Background:

• Primary pineal melanoma is an exceptionally rare intracranial tumor.
• Obstructive hydrocephalus is a common complication of pineal region masses.
• Accurate diagnosis and staging are critical for treatment planning.

Observation:

• A 53-year-old female presented with severe headache.
• Imaging revealed a solitary, black, pigmented mass in the pineal region causing obstructive hydrocephalus.
• Biopsy confirmed primary pineal melanoma without leptomeningeal dissemination.

Findings:

• The patient received chemotherapy with dacarbazine, ACNU, vincristine, and interferon.
• Follow-up imaging demonstrated a dramatic reduction in tumor size.
• No tumor recurrence was observed for 4 years post-treatment.

Implications:

• This case suggests that primary pineal melanoma, even when solitary and without leptomeningeal spread, can be effectively treated with chemotherapy.
• The findings support chemotherapy as a viable option for managing rare intracranial melanomas.
• Further research into optimal chemotherapeutic regimens for primary pineal melanoma is warranted.