Microsurgery for the treatment of primary malignant intracranial melanoma: a surgical series and literature review.

　　AbstractBACKGROUND:

　　Primary malignant intracranial melanomas are rare tumors of the central nervous system. These tumors are highly malignant and are associated with poor prognosis. The field of neurosurgery has struggled with the diagnosis and treatment of these tumors.

　　METHODS:

　　In this study, we present a surgical series of eight patients with primary malignant intracranial melanomas and retrospectively analyze the clinical features, imaging findings, pathological features and prognoses of these patients.

　　RESULTS:

　　All patients underwent microsurgery. Total and subtotal resection of the tumor was achieved in six and two patients, respectively. Of the eight patients, seven showed improvement while one remained the same at time of discharge. There was no neurosurgical deterioration. Radiotherapy was conducted in six patients after operation. The average follow-up duration was 13.8 months (range = 9-26 months). During the follow-up period, three patients died from this disease. One patient suffered from recurrence at the 16th month and underwent second surgery. The other patients were still alive with no evidence of tumor recurrence.

　　CONCLUSION:

　　Microsurgery and radiotherapy should be the first line managements for patients with primary malignant intracranial melanomas. Improvements in chemotherapy, immunotherapy and targeted therapies may provide more effective treatments for malignant intracranial melanomas.