Introduction:

Acral lentiginous melanoma is a subtype of potentially aggressive melanoma and the third primary tumor to cause brain metastases. It debuts with neurological symptoms and intracerebral hemorrhage in 50% of the cases, and affects the palms of the hands, the soles of the feet and the subungual regions. Its prognosis is poor compared to other clinical variants because these melanomas are diagnosed late. They account for 4% of all malignant skin neoplasms and are responsible for 80% of deaths.

Case presentation:

44-year-old male patient, skin phototype IV, who had a lesion on the left foot sole, pigmented and ulcerated, of slow growth, with about 2 years of evolution. The subject underwent surgery for resection of acral lentiginous melanoma 1 year before consultation and was admitted to the emergency department due to sudden neurological symptoms and compromised consciousness. Computed tomography scan of the brain was performed, showing a hyperdense temporoparietal left tumor of 4.1x5cm with perilesional edema and hemorrhage. After stabilization, the patient was referred to a higher level hospital for microsurgical treatment.

Conclusions:

Since metastatic melanomas are incurable, early and timely diagnosis of dermal lesions accessible for inspection to initiate treatment is a priority to improve the prognosis of this disease.

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