Cerebral metastasis - melanoma

Discussion:

The patient went on to have a resection.

Histology

Sections show brain parenchyma with extensive degenerative changes, microglial activation and foamy macrophages. There are separate fragments of necrotic tissue present. A single 2mm fragment of viable tumor composed of epithelioid to spindled cells with abundant pale eosinophilic cytoplasm, oval hyperchromatic nuclei and small nucleoli are present.

Immunohistochemistry shows strong nuclear staining for SOX-10 in the atypical cells seen in the very small tissue fragment. There is also strong cytoplasmic staining for tyrosinase and melan A.

FINAL DIAGNOSIS: extensively necrotic metastatic malignant melanoma.

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