Open Access

CASE REPORT

Differential Diagnosis between Primary Intracranial Melanoma and Cerebral Cavernoma in Crohn’s Disease: A Case Report and Literature Review

by Roberta Costanzo¹, Vishal Parmar², Salvatore Marrone¹, Domenico Gerardo Iacopino¹, Giovanni Federico Nicoletti³, Giuseppe Emmanuele Umana⁴, Gianluca Scalia^3,*

1 Neurosurgery Unit, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, Palermo, Italy
2 School of Medicine, American University of Integrative Sciences, Cole Bay, Barbados
3 Department of Neurosurgery, Highly Specialized Hospital and of National Importance “Garibaldi”, Catania, Italy
4 Department of Neurosurgery, Trauma Center, Gamma Knife Center, Cannizzaro Hospital, Catania, Italy

* Corresponding Author: Gianluca Scalia. Email:

Oncologie 2022, 24(4), 937-942. https://doi.org/10.32604/oncologie.2022.027155

Received 17 October 2022; Accepted 05 December 2022; Issue published 31 December 2022

Abstract

Primary intracranial melanomas are rare, with a challenging diagnosis based only on clinical and imaging features. The authors described the case of an intracerebral right parieto-temporal melanoma mimicking a cavernoma in a patient affected by Crohn’s disease. A 67-year-old female patient with Crohn’s disease and small bowel stenosis was hospitalized for surgical removal of the terminal ileum and latero-lateral ileo-colic anastomosis. During postoperative week 1, the patient developed psychomotor agitation followed by altered consciousness. An urgent brain CT showed a right intracerebral parieto-temporal hemorrhage with intralesional calcifications. The patient underwent a decompressive craniectomy with hematoma drainage and a complete resection of the lesion. Histologic examination showed characteristics consistent with malignant melanoma. In patients with inflammatory bowel disease (IBD), the differential diagnosis between intracerebral melanoma and cavernoma may be challenging, considering the similar clinical and radiological findings. Thus, a comprehensive multidisciplinary approach is required to exclude the possible coexistence of such intracranial lesions.

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