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Huang JB, Xue HJ, Zhu BY, Lei Y, Pan L. Primary thoracolumbar intraspinal malignant melanoma: A case report. World J Clin Cases 2024; 12:2904-2910. [PMID: 38899297 PMCID: PMC11185348 DOI: 10.12998/wjcc.v12.i16.2904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 04/08/2024] [Accepted: 04/19/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Primary intraspinal malignant melanoma is a very rare tumor that most often occurs in the cervical, thoracic, or thoracolumbar segment. CASE SUMMARY A rare case of primary thoracolumbar malignant melanoma is described. A 45-year-old female patient complained of low back pain with numbness and fatigue in both lower limbs. MR revealed an intradural space-occupying lesion at the thoracic 12 to lumbar 1 level. The tumor was partially excised, and a malignant melanoma was confirmed by histopathology. CONCLUSION Primary intraspinal malignant melanoma has rarely been reported, and surgical resection and related characteristics and diagnoses have been discussed.
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Affiliation(s)
- Jie-Bin Huang
- Department of Bone, Sanshui District People's Hospital of Foshan City, Foshan 528100, Guangdong Province, China
| | - Hou-Jun Xue
- Department of Bone, Sanshui District People's Hospital of Foshan City, Foshan 528100, Guangdong Province, China
| | - Bai-Yong Zhu
- Department of Bone, Sanshui District People's Hospital of Foshan City, Foshan 528100, Guangdong Province, China
| | - Yu Lei
- Department of Bone, Sanshui District People's Hospital of Foshan City, Foshan 528100, Guangdong Province, China
| | - Lei Pan
- Department of Bone, Sanshui District People's Hospital of Foshan City, Foshan 528100, Guangdong Province, China
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Lewis D, Dawson TP, Hyde R, Rata GA, Alalade AF, Ghosh K, Elhabal A. A rare case of multifocal craniospinal leptomeningeal melanocytoma: A case report and scoping review. BRAIN & SPINE 2024; 4:102797. [PMID: 38601773 PMCID: PMC11004071 DOI: 10.1016/j.bas.2024.102797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 03/23/2024] [Accepted: 03/30/2024] [Indexed: 04/12/2024]
Abstract
Introduction Leptomeningeal melanocytomas are rare tumours originating from neural crest derived melanocytes. They are usually solitary and presentation with multifocal meningeal melanocytoma is very rare and indicative of potentially more aggressive behaviour. This case report and scoping review sought to evaluate the presentation, and key radiological features that can help differentiate multifocal meningeal melanocytoma from other differentials and provide a discussion of the key management and prognostic points once these tumours are diagnosed. Case presentation A 26 year old male presented with neck pain radiating to both shoulders and subjective weakness in left shoulder movement. MRI demonstrated a large enhancing C2-C3 intradural-extramedullary lesion with further lesions at the T7/T8 level, left cerebellopontine angle and midline suprachiasmatic region. Whilst the imaging appearances were initially thought be indicative of a phacomatosis such as NF2-related schwannomatosis, surgical excision of the cervical tumour confirmed a melanocytic tumour of leptomeningeal origin, consistent with multifocal meningeal melanocytoma. Patient made a good post-operative recovery and remains under half yearly radiological surveillance, with repeat MRI 6 months after surgery demonstrating subtle growth of the untreated intracranial and spinal lesions. Literature review and conclusions This is the first description, to our knowledge, of a multifocal meningeal melanocytoma associated with both cerebellopontine angle and suprasellar lesions. This case and included scoping review highlight the need to consider this rare diagnosis whenever multifocal craniospinal lesions are encountered, and the need to consider aggressive management through surgical resection and adjuvant craniospinal radiotherapy once these tumours are diagnosed.
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Affiliation(s)
- Daniel Lewis
- Department of Neurosurgery, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Timothy P. Dawson
- Department of Neuropathology, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, UK
| | - Rebecca Hyde
- Department of Neuroradiology, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, UK
| | - George Adrian Rata
- Department of Neurosurgery, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - Andrew F. Alalade
- Department of Neurosurgery, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - Kaushik Ghosh
- Department of Neurosurgery, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - Ahmed Elhabal
- Department of Neurosurgery, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
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Clampitt B, Monsour M, Kazelka M, Schimmel S, Croci DM. Intraoperative View of a Multinodal, Paralysis-Inducing Spinal Melanocytoma: Case Report and Literature Review. World Neurosurg 2024; 181:2. [PMID: 37777173 DOI: 10.1016/j.wneu.2023.09.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 10/02/2023]
Abstract
Melanocytomas arising from the leptomeningeal melanocytes within the central nervous system are a rare occurrence, accounting for 0.06%-0.1% of brain tumors and having an incidence of 1/10 million people per year.1-14 Here, we describe the case of 68-year-old male presenting with bilateral lower extremity weakness progressing to paralysis and urinary incontinence (Video 1). Upon examination, this gentleman had no sensation below T11. Magnetic resonance imaging showed multiple contrast-enhancing lesions with a major intradural lesion at level T11 arising from the ventrolateral surface and causing severe spinal cord compression. The multifocal nature of this tumor further adds to its rarity. Interdisciplinary indication for surgical resection of the intradural lesion was made. This was accomplished through a T11 laminectomy and concomitant T11-12 stabilization with neuromonitoring. Pathologic analysis of the resected tumor identified an S100+, HMB45+, pigmented melanocytoma. No complications occurred during the procedure. The patient was discharged to rehabilitation with persistent neurologic deficits. Routine follow-up is indicated given the high rates of recurrence and the multiple remaining tumor nodules.14.
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Affiliation(s)
- Bryan Clampitt
- USF Health, Morsani College of Medicine, Tampa, Florida, USA
| | - Molly Monsour
- USF Health, Morsani College of Medicine, Tampa, Florida, USA
| | - Maryam Kazelka
- USF Health, Morsani College of Medicine, Tampa, Florida, USA
| | | | - Davide Marco Croci
- Department of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, Florida, USA; Department of Neurosciences, Lakeland Regional Hospital, Lakeland, Florida, USA.
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How Should We Treat Meningeal Melanocytoma? A Retrospective Analysis of Potential Treatment Strategies. Cancers (Basel) 2022; 14:cancers14235851. [PMID: 36497333 PMCID: PMC9738837 DOI: 10.3390/cancers14235851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/11/2022] [Accepted: 11/20/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Meningeal melanocytomas (MM) are rare primary melanocytic tumors of the leptomeninges with an incidence of 1:10,000,000. Until now, there has been only sparse information about this tumor entity. Here, we provide a meta-analysis of all cases published in the English language since 1972. METHODS A literature review was performed using PubMed and Web of Science. All published cases were evaluated for location, sex, age, therapeutic approach, and outcome. In total, we included 201 patient cases in our meta-analysis. RESULTS The majority of MM was diagnosed more frequently in men between the third and fifth decade of life. Surgery is the preferred therapeutic approach, and total resection is associated with the best outcome. Patients with partial resection or tumor recurrence benefit from adjuvant radiotherapy, whereas chemo- or immunotherapies do not improve the disease course. Malignant transformation was described in 18 patients. Of these, 11 patients developed metastasis. CONCLUSIONS We present the first retrospective meta-analysis of all MM cases published in the English language, including an evaluation of different treatment strategies allowing us to suggest a novel treatment guideline highlighting the importance of total resection for recurrence-free survival and characterizing those cases which benefit from adjuvant radiotherapy.
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Deng SL, Wang YB, Wang DH, Zhan S, Jing Y, Guan Y. Malignant Transformation and Metastatic Spread of Dumbbell-Shaped Meningeal Melanocytoma of the Cervical Spine: A Case Report and Literature Review. Front Surg 2022; 9:789256. [PMID: 35402475 PMCID: PMC8983910 DOI: 10.3389/fsurg.2022.789256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 02/25/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundMeningeal melanocytoma is a rare disease that originates from leptomeningeal melanocytes in the central nervous system. Meningeal melanocytoma is generally considered benign, and has a good prognosis following complete surgical resection. Reports of the malignant transformation and spread of these tumors are scarce.Case PresentationA 19 year old female presented with headache, progressive limb weakness, and dyspnea. Magnetic resonance imaging showed a dumbbell-shaped lesion at C1–C2 that was hyperintense on T1 weighted images and showed strong contrast enhancement. Total resection was achieved using a posterior midline approach. Post-operative pathology showed meningeal melanocytoma. The tumor recurred 9 months later with intracranial spread. Resection of the lesion revealed malignant transformation to meningeal melanoma.ConclusionMeningeal melanocytoma harbors malignant potential even with total resection. Radiotherapy could be considered to prevent disease recurrence and progression.
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Affiliation(s)
- Shuang-lin Deng
- Department of Oncological Neurosurgery, First Hospital of Jilin University, Changchun, China
| | - Yu-bo Wang
- Department of Oncological Neurosurgery, First Hospital of Jilin University, Changchun, China
| | - Dan-hua Wang
- Department of Pathology, First Hospital of Jilin University, Changchun, China
| | - Shuang Zhan
- Department of Oncological Neurosurgery, First Hospital of Jilin University, Changchun, China
| | - Yi Jing
- Department of Oncological Neurosurgery, First Hospital of Jilin University, Changchun, China
| | - Yi Guan
- Department of Oncological Neurosurgery, First Hospital of Jilin University, Changchun, China
- *Correspondence: Yi Guan
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Shaikh ST, Gupta GS, Mohanty CB, Deopujari CE. Spinal Nerve Root Extradural Melanocytoma Progressing to Malignant Melanoma: A Case Report with Review of Literature. Asian J Neurosurg 2021; 16:394-397. [PMID: 34268173 PMCID: PMC8244717 DOI: 10.4103/ajns.ajns_416_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 02/15/2021] [Indexed: 11/17/2022] Open
Abstract
Melanocytomas are rare benign pigmented tumors arising from the leptomeninges with a very remote chance of progressing to malignant melanoma. They have a predilection for occurring in the posterior fossa or in the intradural extramedullary region of the cervical spine. We report the first case of malignant transformation of a nerve root (extradural) melanocytoma wherein immunotherapy has been added for its treatment. Only four such cases of malignant transformation of central nervous system melanocytoma have been reported in the literature. Definite diagnosis in such cases is based on immunohistochemistry evaluation. Surgical resection with adjuvant radiotherapy and immunotherapy is the recommended treatment.
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Affiliation(s)
- Salman T Shaikh
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India
| | - Gaurav S Gupta
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India
| | - Chandan B Mohanty
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India
| | - Chadrashekhar E Deopujari
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India
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Kinnen F, Fleck SK, Baldauf J, Hans V, Daeschlein G, Rathmann E, Schroeder HWS, Marx S. Primary leptomeningeal melanocytic tumors of the spine: report of two cases and review of the literature. World Neurosurg 2019; 124:228-236. [PMID: 30660881 DOI: 10.1016/j.wneu.2019.01.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 01/06/2019] [Accepted: 01/08/2019] [Indexed: 10/27/2022]
Abstract
Primary leptomeningeal melanocytic tumors of the central nervous system are rare and especially in the spine less frequent compared to other entities. There is no consensus regarding the best care of these tumors. We report two cases of primary leptomeningeal melanocytic tumors, one PLM (Primary Leptomeningeal Melanoma) and one PLMC (Primary Leptomeningeal Melanocytoma) of the upper cervical spine and emphasize different surgical findings and clinical courses of these patients. A review of the literature according to primary leptomeningeal melanocytic tumors of the spine was done, especially to compare different treatment modalities in the younger history. Primary melanocytic tumors of the spine are exceedingly rare. Prior to surgery it is difficult to make a correct diagnosis. Usually an unexpected intraoperative finding with consecutive histopathological analyses lead to the final diagnosis. An accurate search for melanocytic tumors outside the CNS as primary source is mandatory. PLMC have a better prognosis than PLM. There is no consensus regarding the adjuvant therapy, but PLM patients should be given radiotherapy, chemotherapy and immunotherapeutical approaches as immune checkpoint blockade after surgery. Communicating hydrocephalus is highly associated to PLM, but may occur in PLMC as well.
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Affiliation(s)
| | | | - Jörg Baldauf
- Department of Neurosurgery, University Medicine Greifswald
| | | | | | - Eiko Rathmann
- Institute of Radiology, University Medicine Greifswald
| | | | - Sascha Marx
- Department of Neurosurgery, University Medicine Greifswald.
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Pierson M, Marwaha N, Guzman M, Mikulec AA, Coppens JR. Multifocal melanocytoma of the posterior fossa and subcutaneous scalp in the absence of neurocutaneous melanosis. Surg Neurol Int 2016; 7:S591-5. [PMID: 27656317 PMCID: PMC5025953 DOI: 10.4103/2152-7806.189728] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 06/16/2016] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Primary leptomeningeal melanocytic neoplasms of the central nervous system are rare. Multifocal lesions typically occur in the setting of cutaneous melanosis. We present the first report of a posterior fossa melanocytoma and subcutaneous melanocytoma of intermediate grade in the absence of cutaneous melanosis. CASE DESCRIPTION We present the case of a 22-year-old male with decreased hearing on the right side, ataxia, nausea, vomiting and a scalp mass. Magnetic resonance imaging (MRI) demonstrated occipital and cerebellopontine (CP) angle masses. The patient underwent gross total resection of the scalp mass and subtotal resection of the CP angle mass. Pathologic examination revealed melanocytoma with intermediate grade. The patient underwent stereotactic radiosurgery to the residual CP angle tumor. This case represents, to the author's knowledge, the first report associating a posterior fossa melanocytoma with a subcutaneous melanocytoma of intermediate grade in the absence of cutaneous melanosis. CONCLUSION This case introduces the first report of a new variant of multifocal melanocytoma which is not confined to the central nervous system.
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Affiliation(s)
- Matt Pierson
- Department of Neurosurgery, Saint Louis University, Saint Louis, Missouri, USA
| | - Nitin Marwaha
- Department of Pathology, Saint Louis University, Saint Louis, Missouri, USA
| | - Miguel Guzman
- Department of Pathology, Saint Louis University, Saint Louis, Missouri, USA
| | - Anthony A Mikulec
- Department of Otolaryngology, Saint Louis University, Saint Louis, Missouri, USA
| | - Jeroen R Coppens
- Department of Neurosurgery, Saint Louis University, Saint Louis, Missouri, USA
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9
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Marwaha N, Batanian JR, Coppens JR, Pierson MJ, Richards-Yutz J, Ebrahimzadeh J, Ganguly A, Guzman MA. Subcutaneous melanocytoma mimicking a lipoma: a rare presentation of a rare neoplasm with histological, immunohistochemical, cytogenetic and molecular characterization. J Cutan Pathol 2016; 43:1186-1196. [PMID: 27573466 DOI: 10.1111/cup.12808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 08/09/2016] [Accepted: 08/19/2016] [Indexed: 01/06/2023]
Abstract
Melanocytoma are the melanocytic tumors originating from leptomeningeal melanocytes. Melanocytomas are commonly seen in the central nervous system (CNS) and are often associated with neurocutaneous melanosis (NCM). However, simultaneous presentation of intra-axial and extracranial melanocytoma is a very rare event. Here, we report a unique case of 21-year-old male with intermediate-grade subcutaneous (SC) melanocytoma, mimicking lipoma, occurred synchronously with an intracranial melanocytoma, not associated with NCM. A 21-year-old Caucasian male presented to the emergency department (ED) with severe vertigo and vomiting. A magnetic resonance imaging (MRI) of the brain was performed at the ED, which revealed an SC mass in the right occipital scalp and a right cerebellopontine angle (CPA) mass. Excision of the SC mass revealed a well-circumscribed highly pigmented melanocytic tumor. The SC mass tumor cells were positive for melanocytic lineage markers. The histopathological features were between benign melanocytomas and malignant melanomas. The Ki67 and PHH3 IHCs confirm the intermediate grade of the tumors. An array-CGH (comparative genome hybridization) and next-generation sequencing analysis of the tumor DNA extracted from the formalin-fixed paraffin-embedded tissue reveals chromosome 6p gain and p.Q209P mutation in the GNAQ gene, respectively, consistent with the diagnosis of intermediate-grade melanocytoma.
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Affiliation(s)
- Nitin Marwaha
- Department of Pathology, Saint Louis University School of Medicine, St. Louis, MO, USA
| | - Jacqueline R Batanian
- Department of Pathology, Saint Louis University School of Medicine, St. Louis, MO, USA
| | - Jeroen R Coppens
- Department of Neurosurgery, Saint Louis University School of Medicine, St. Louis, MO, USA
| | - Matthew J Pierson
- Department of Neurosurgery, Saint Louis University School of Medicine, St. Louis, MO, USA
| | - Jennifer Richards-Yutz
- Department of Genetics, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Jessica Ebrahimzadeh
- Department of Genetics, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Arupa Ganguly
- Department of Genetics, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Miguel A Guzman
- Department of Pathology, Saint Louis University School of Medicine, St. Louis, MO, USA
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Orbital meningeal melanocytoma: Histological, immunohistochemical and molecular characterization of a case and review of the literature. Pathol Res Pract 2016; 212:946-953. [PMID: 27499153 DOI: 10.1016/j.prp.2016.07.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 07/18/2016] [Indexed: 12/21/2022]
Abstract
AIMS We provide morphological, immunohistochemical and molecular characterization of the 3rd "intermediate-grade" orbital meningeal melanocytoma, testing for the first time Vysis Melanoma FISH Probe Kit. We reviewed the literature in order to discuss the main differential diagnoses and to provide a better molecular description of these unusual tumors of difficult diagnosis and controversial management. METHODS Histochemical stains (Haematoxylin and Eosin, Perls, reticulin), immunohistochemistry (HMB45, p16, Melan-A, S100, EMA, Ki67, CD68), polymerase chain reaction amplification and sequence analysis (BRAF, exon 15; NRAS exons 2 and 3; c-KIT, exons 11, 13, 17, 18; GNAQ, exons 4 and 5; GNA11, exons 4 and 5) and fluorescent in situ hybridization (RREB1, 6p25; MYB, 6q23; CCND1, 11q13; CEP 6, 6p11.1-q11.1) were performed on paraffin-embedded, formalin-fixed material. RESULTS Histological diagnosis of "intermediate-grade" melanocytoma was supported by zonal necrosis and increased Ki67-index (12%). Immunophenotype: HMB45+(strong, >75%), Melan-A+(strong, >75%), p16+(∼20%), S100 -/+ (<5%), EMA -/+ (<5%), CD68 - (positive histiocytes). No gene mutations nor copy-number alterations were identified. The patient was asymptomatic and disease-free 3 years after total surgical excision. CONCLUSIONS Adequate sampling and accurate immunohistochemical characterization are important for a correct diagnosis. Molecular analysis could provide important additional information (especially for "intermediate-grade" tumors), but further data are needed.
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Yang C, Fang J, Li G, Yang J, Xu Y. Primary scattered multifocal melanocytomas in spinal canal mimicking neurofibromatosis. Spine J 2016; 16:e553-9. [PMID: 26970601 DOI: 10.1016/j.spinee.2016.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Revised: 02/04/2016] [Accepted: 03/04/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Meningeal melanocytoma is an extremely rare pigmented tumor derived from leptomeningeal melanocytes. By and large, it is considered to be a well-differentiated and slow-growing benign lesion. Generally, meningeal melanocytomas are solitary lesions, and the occurrence of the primary multifocal form in the central nervous system is exceedingly rare; it has been previously reported in only six cases. PURPOSE The present report illustrates a 41-year-old woman with primary multifocal meningeal melanocytoma in the spinal canal. Contrary to earlier reports, the tumors presented with a scattered appearance mimicking neurofibromatosis. STUDY DESIGN This study is a case report and review of literature. METHODS On admission, the cerebral magnetic resonance images of the patient were normal, whereas the spinal magnetic resonance images showed scattered multifocal nodules mimicking neurofibromatosis. Surgical resection of the responsible lesions was scheduled. In addition to this case presentation, relevant previous reports were reviewed, and the challenging diagnosis, management, and prognosis of meningeal melanocytoma are discussed. RESULTS Gross total resection of the two largest lesions was achieved, and histopathological examinations confirmed the diagnosis. Despite the benign histopathological findings, the patient had an aggressive clinical course. On follow-up at 18 months after surgery, she succumbed to the disease. CONCLUSION Clinicians should be alert to a potential aggressive clinical course of meningeal melanocytoma, despite its benign histopathological nature. Of particular note is multifocality and diffuse leptomeningeal hyperpigmentation, which may suggest a poor prognosis. A combined treatment including surgical resection and adjuvant radiotherapy should be considered, and long-term close follow-up is necessary.
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Affiliation(s)
- Chenlong Yang
- Department of Neurosurgery, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing 100050, China
| | - Jingyi Fang
- Department of Neuro-pathology, Beijing Neurosurgical Institute, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing 100050, China
| | - Guang Li
- Department of Pathology, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing 100050, China
| | - Jun Yang
- Department of Neurosurgery, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing 100050, China
| | - Yulun Xu
- Department of Neurosurgery, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing 100050, China.
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