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Brain Metastasis — RACP Adult Medicine MCQ

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EasyMedical OncologyBrain MetastasisRACP Adult Medicine

A 68-year-old man presents with new-onset seizures. MRI brain shows a ring-enhancing lesion in the right temporal lobe with surrounding oedema. He has a history of a melanoma excised 3 years ago. What is the most likely diagnosis?

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Correct answer: D — Cerebral metastasis from melanoma

Melanoma is one of the cancers most likely to metastasise to the brain (along with lung, breast, renal, and colorectal). A ring-enhancing lesion with surrounding oedema in a patient with prior melanoma is most likely a cerebral metastasis. MRI with contrast is the investigation of choice. Management depends on the number and location of metastases and includes surgery, stereotactic radiosurgery, whole-brain radiation, and systemic therapy (immunotherapy for melanoma brain metastases has shown benefit).

Reference: Cancer Council Australia – 2020 – Melanoma Clinical Practice Guidelines