Delayed heamatoma after melanoma metastasis resection upon restart of Immunotherapy: Case Report and Review of the Literature
Published in: Neuro-Oncology
Authors: Ali Elhag; Jose Pedro Lavrador; Joseph Frantzias; Ahilan Kailaya-Vasan; et al.; Ranjeev S. Bhangoo
Year: 2018
Publication details: 21(Suppl 4):iv19
DOI: 10.1093/neuonc/noz167.086
Publication type: Case report and review
Topic: brain metastasis, melanoma, immunotherapy, postoperative bleeding, case report
Simple summary
The publication is useful for explaining the complexity of brain metastasis care, particularly where neurosurgery overlaps with modern oncology treatments. For patient-facing content, it should be framed carefully as a case report rather than generalised evidence.
Mr Kailaya-Vasan’s involvement
Mr Kailaya-Vasan, consultant neurosurgeon and neurovascular surgeon, is listed as a contributing author on this publication.
Published abstract
The following abstract is reproduced from the original publication and is provided for reference. It may include technical terminology intended for clinical or academic audiences.
Supratentorial metastatic melanomas are common and increasingly treated with immunotherapy. While improving the outcome, immunotherapy potentially increases the risks of intracranial surgical procedures, particularly bleeding. However, scarce reports address this complication. Case Description: A 52-year-old male with a history of right upper limb excised skin lesion resected with wide local excision 6 months prior to admission presented with a three-week history of progressive headaches, vomiting, odd behaviours, forgetfulness and left lower-sided weakness. Brain imaging showed a right frontal lesion with evidence of haemorrhage within it, with midline shift and mass effect. He underwent craniotomy and resection of the lesion with no post-operative complication, resolution of left-sided hemiparesis and post-operative imaging documenting complete resection and no post-operative complications. The histopathology confirmed metastatic melanoma and he received adjuvant immunotherapy (Nivolumab); however, he represented 4 weeks post-operatively with sudden onset headache with vomiting and no neurological deficit. Brain imaging showed a delayed haematoma in the surgical site. Conclusions: This case report highlights the risk of post-operative bleeding with immunotherapy and paves the way for further studies with regards to the safety of immunotherapy after intracranial procedures.
Disclaimer
This publication page is provided for general information about Mr Kailaya-Vasan’s academic work. It is not medical advice and should not be used to guide individual diagnosis or treatment decisions. Patients should discuss their individual symptoms, diagnosis and treatment options with a specialist.