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PLoS One. 2016 May 23;11(5):e0156115. doi: 10.1371/journal.pone.0156115. eCollection 2016.

Cutaneous Melanoma with Brain Metastasis: Report of 193 Patients with New Observations.

Author information

1
Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland.
2
Departments of Pathology and Translational Research, Institut Curie, Paris, France.
3
Department of Biostatistics, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
4
Cancer Registry Zurich and Zug, Institute of Surgical Pathology, University Hospital Zurich and Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
5
Institute of Neuropathology, University Hospital Zurich, Zurich, Switzerland.

Abstract

BACKGROUND:

Brain metastasis is a common endpoint in patients suffering from malignant melanoma. However, little is known about factors that predispose to brain metastases.

OBJECTIVE:

We performed a retrospective clinical and pathological investigation of melanoma patients with brain metastases in order to better characterise this patient population.

METHODS:

193 melanoma patients with brain metastasis histologically diagnosed between 1990 and 2015 at the University Hospital Zurich were retrospectively identified and further specified for sex, age at diagnosis and detection of brain metastasis, and localisation. In addition, data were extracted regarding the subtype of primary melanoma, Breslow tumour thickness, Clark Level, mutation status, extent of metastatic spread and history of a second melanoma.

RESULTS:

We found a significant male predominance (n = 126/193; 65%; p < 0.001). Breslow tumour thickness showed a wide range from 0.2 to 12.0 mm (n = 99; median 2.3 mm). 14 of 101 melanomas (14%) were classified as T1, thereof 11 (79%) were found in men. In 32 of 193 patients (17%), the primary melanoma was unknown.

CONCLUSIONS:

Of special interest in our series is the high incidence of male predominance (79%) in cases of thin metastasing melanoma (14%), implicating genetic or epigenetic (hormonal) gender differences underlying tumour progression. Additionally, the high percentage of unknown primary melanoma (17%), at least partly representing completely regressed melanomas, indicates the importance of immune surveillance in melanoma progression.

PMID:
27213536
PMCID:
PMC4877095
DOI:
10.1371/journal.pone.0156115
[Indexed for MEDLINE]
Free PMC Article

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