RESUMO
BACKGROUND: Melanoma lesions in the brainstem can be difficult to distinguish radiographically and clinically from cavernous malformations. However, the treatment modalities and clinical course of these two diseases differ considerably. We report two cases of melanoma presenting as brainstem hemorrhages. CASE DESCRIPTION: A 69-year-old male was found to have a hemorrhagic lesion of the right dorsal midbrain. After a repeat hemorrhage, the lesion was resected and found to be hyperchromatic. Nonetheless, the patient suffered rebleeding and died 3 months later. A 62-year-old female was similarly found to have an acute pontine hemorrhage. After resection of the lesion, she underwent whole-brain radiation therapy but ultimately died 5.5 months later. The histopathology of both lesions was consistent with melanoma. CONCLUSIONS: Melanoma in the brainstem can mimic cavernous malformations. While management of these lesions includes stereotactic radiosurgery, whole-brain radiation, and surgical resection, metastatic brainstem melanoma follows an aggressive clinical course with a poor prognosis.
Assuntos
Neoplasias do Tronco Encefálico/diagnóstico , Hemangioma Cavernoso do Sistema Nervoso Central/diagnóstico , Melanoma/diagnóstico , Idoso , Neoplasias do Tronco Encefálico/patologia , Neoplasias do Tronco Encefálico/cirurgia , Diagnóstico Diferencial , Evolução Fatal , Feminino , Hemangioma Cavernoso do Sistema Nervoso Central/patologia , Hemangioma Cavernoso do Sistema Nervoso Central/cirurgia , Humanos , Hemorragias Intracranianas/etiologia , Masculino , Melanoma/patologia , Melanoma/cirurgia , Pessoa de Meia-Idade , Metástase Neoplásica/patologia , Prognóstico , Radiocirurgia , Resultado do TratamentoRESUMO
The prevalence of haemoglobin S in Ghana is well documented. A study seeking to determine the prevalence of sensorineural deafness in Ghanaian sickle cell anaemia patients was conducted. About 29% of the SS-patients studied showed hearing losses ranging from 30 to 60 dB in the high frequency range of 4 to 8 kHz. This observation was favourable compared to those made by different workers among geographically different populations.
