Relatamos o caso de um paciente, de 28 anos, portador de nevo melanocítico gigante congênito(NMGC), com transformação em melanoma e metastátase no sistema nervoso central (SNC). Descrevemos resumidamente as características patológicas de ambas as lesões(NMGC e melanoma), a frequência de malignização do NMGC, os órgãos mais frequentemente acometidos pelas metastases do melanoma - dando ênfase ao acometimento do SNC - além dos fatores que podem levar à malignização do NMGC, os exames usados para o diagnóstico das metástases no SNC - ressaltando a importância do líquido cefalorraquiano - e algumas modalidades terapêuticas para o melanoma com acometimento do SNC.

We describe the case of a 28-year-old man with a giant congenital melanocytic nevus (GCMN) with malignant transformation to melanoma and metastasis on the central nervous system (CNS). We also make a summary of the pathological features from both lesions(GCMN and melanoma), the occurrence of malignancy of GCMN, the organs more frequently involved with metastatic melanoma - with emphasis to involvement of CNS -just as the factors that cause malignant transformation of GCMN; the methods to diagnose metastases in CNS - emphasizing the importance of cerebrospinal fluid - and some therapeutical modalities for the metastatic melanoma in CNS.

Capsular polysaccharide antigen (AgPC) of Cryptococcus neoformans was detected by latex agglutination technique (LA) in cerebrospinal fluid and serum of patients with AIDS during their first central nervous system manifestation of the disease. Direct mycological examination and culture were used as controls. Sensitivity was 100% by LA allowing an early specific treatment of cryptococcosis. Initial titres of AgPC in such patients can be > 1000000 and it appears that when such titres are present in the serum they are related to mortality during treatment. Surviving patients showed positivity of the direct mycological examination and AgPC of C. neoformans in cerebrospinal fluid and sera even after treatment and clinical recovery.

Antígeno del polisacárido capsular (Ag PC) de Cryptococcus neoformans fue detectado por la técnica de aglutinación de latex (AL) en LCR y suero de pacientes con Sindrome de Inmunodeficiencia Adquirida (SIDA) y primer episodio de neurocriptococosis, usando como patrón el examen micológico (examen directo y cultivo) de LCR. Se obtuvo una sensibilidad del 100% de AL para detectar AgPC de C. neoformans, el cual por su rápidez permite tratamiento específico precoz. Títulos iniciales de AgPC de la levadura en esos pacientes pueden ser > 1.000.000, pareciendo que cuando esos títulos están presentes en suero, se relacionan con mortalidad durante el tratamiento. En los pacientes que sobrevivieron se observó que el examen micológico directo y AgPC de C. neoformans, en LCR y suero, permanecen positivos aún después de tratamiento y mejoría clínica del paciente.