1Damelan Kombate, 2Saka Bayaki, 2Waklatsi Panabalo, 1Dare Tchin, 2Assogba Komi, 2Balogou Aa. Koffi
1University of Kara, Kara, Togo; 2University of Lomé, Lomé, Togo
Brain hemorrhagic metastases are the prerogative of certain cancers (some cancer has a propensity to give rise hemorrhagic metastasis, so is melanoma). Malignant melanoma is rare in among black population and the diagnosis is done lately. This fact leads to a more aggressiveness of the lesion. Brain metastases are often of bad outcome, especially in a context of poor technical platform.
We purpose to underline across a case report, the main difficulties of brain hemorrhagic metastasis management in low-income country.
We report a case of brain hemorrhagic metastases in a 77-year-old woman with a history of malignant melanoma of the foot without appropriate management. She was admitted with deterioration of the conscience and high intracranial pressure. The physical examination noted a state of obnubilation with a Glasgow Score Coma quoted at 10/15, a pyramidal syndrome of the 4 limbs, motor aphasia and sphincter disorders. Brain CT displayed multifocal hemorrhagic brain lesions highly suggestive of cerebral melanoma metastasis. Despite high-dose corticosteroid therapy and analgesic treatment, the patient died two weeks after admission in a context of high intracranial pressure.
Brain metastases are compelling disease. In the presence of hemorrhagic metastases, malignant melanoma should be considered. The outcome is often fatal.