Background Patients with melanoma metastasized to the central nervous system have a poor prognosis.Becausethe incidence of malignant melanoma in the Oriental is lower than that in the Caucasian population,brain metastases ofmalignant melanoma are rarely reported in Asia.Here we present our experience of brain metastasis of melanoma in anAsian perspective.Methods From 1990 to 2003,369 patients with melanoma were treated in our hospital,26 of them were diagnosed ashaving central nervous system involvement.Of the 26 cases,the clinical history,image,and pathologic findings of 23patients were analyzed;the other 3 were excluded because of incomplete clinical data.Results Among the 369 patients with melanoma,45% (167/369) developed lower extremity melanoma,and 27.1%(100/369) had acral lentiginous melanoma (ALM);while in the 23 patients with brain metastases,34.7% (8/23) hadlower extremity melanoma,and 34.7% (8/23) had ALM.Among the 23 patients,17 had acute hemorrhage into the tumor,8 initially presented with a single cerebral metastatic lesion,and 15 had multiple brain lesions.Ten of them receivedsurgery,3 underwent stereotactic radiosurgery,and 16 received whole brain radiation.During follow-up,only 2 patientssurvived for more than 1 year,the median survival period was 5 months.The longest follow-up period was 11 years.Conclusions Compared with the Caucasian,Chinese patients with melanoma have a different proportion ofmelanoma subtype and higher incidence rates of lower extremities melanoma and ALM.However,their clinicalpresentation and prognosis are similar.The patients,who have excisable single or multiple brain lesions or limitedextracranial disease and who are actively treated,may survive longer.Chin Med J 2007;120(12):1058-1062 Background Patients with melanoma metastasized to the central nervous system have a poor prognosis. Because the incidence of malignant melanoma in the Oriental is lower than that in the Caucasian population, brain metastases of malignant melanoma are rarely reported in Asia. Here we present our experience of brain metastasis of melanoma in an Aspect perspective. Methods From 1990 to 2003, 369 patients with melanoma were treated in our hospital, 26 of them were diagnosed ashaving central nervous system involvement. Of the 26 cases, the clinical history, image, and pathologic findings of 23patients were analyzed; the other 3 were excluded because of incomplete clinical data. Results Among the 369 patients with melanoma, 45% (167/369) developed lower extremity melanoma, and 27.1% (100/369) had acral lentiginous melanoma (ALM); while in the 23 patients with brain metastases, 34.7% (8/23) hadlower extremity melanoma, and 34.7% (8/23) had ALM. Among the 23 patients, 17 had acute hemorrhage into the tumor, 8 initiall y presented with a single cerebral metastatic lesion, and 15 had multiple brain lesions. Ten of those received surgry, 3 underwent stereotactic radiosurgery, and 16 received whole brain radiation. Fluid follow-up, only 2 patientssurvived for more than 1 year, the median survival period was 5 months.The longest follow-up period was 11 years.Conclusions Compared with the Caucasian, Chinese patients with melanoma have a different proportion ofmelanoma subtype and higher incidence rates of lower extremities melanoma and ALM .However, their clinical presentation and prognosis are similar . The patients, who have excisable single or multiple brain lesions or limitedextracranial disease and who are actively treated, may survive longer. Chin Med J 2007; 120 (12): 1058-1062