Extensive central nervous system XXXX : a case report and review of the literature.

@entity1 @entity3852 @entity5 @entity3 @entity272 @entity10
INTRODUCTION: @entity3852 is a rare malignant cutaneous @entity5 that is locally invasive and frequently metastasizes to lymph nodes, liver, lungs, bone and brain. The incidence of @entity3852 has increased in the past three decades. CASE PRESENTATION: A 65-year-old Caucasian @entity1 presented with a sudden onset of severe @entity10 and a three-month history of balance disturbance. Magnetic resonance imaging revealed a large meningeal @entity3 . The radiologic workup showed retroperitoneal and inguinal lymph node @entity3 . Biopsy of the inguinal lymph nodes showed @entity3852 . Biopsy from three different suspected @entity272 revealed no @entity3852 , and the primary @entity3852 remained unknown. @entity3 , new axillary lymph node @entity3 , and intraspinal (epidural and intradural) @entity3 were detected within six, seven and eight months, respectively, from the start of symptoms despite treating the intracranial @entity3 with gamma knife and the abdominal @entity3 with surgical dissection and external radiotherapy. This indicates the aggressive nature of the disease. CONCLUSION: To the best of our knowledge, this is the first report in the literature of an intracranial meningeal @entity3 of @entity3852 treated with gamma knife and of intraspinal intradural @entity3852 . Despite good initial response to radiotherapy, recurrence and occurrence of new @entity3 are common in @entity3852 .
