Hemorrhagic brain metastases as a manifestation of metastatic malignant melanoma

A 53- year-old woman was admitted with chief complaints of progressive dyspnea, numbness, and paresthesia of the right side which had lasted for one month. Four years earlier, her right big toe had amputated due a diagnosis of acral lentiginous melanoma. She had had no problems for three years but then developed cervical lymphadenopathy. Excisional biopsy revealed metastatic melanoma. She also had a thyroid nodule which was proved to be papillary thyroid carcinoma based on fine needle aspiration (FNA) results. Because of metastatic malignant melanoma, she received chemotherapy and radiotherapy. Chest X-ray showed multiple round nodules (Figure 1) and brain computed tomography (CT) scan was in favor of multiple round hyperdense lesions with surrounding edema (Figures 2A, 2B, and 2C).