Case ReportBrain Atrophy Associated with Primary Diffuse Meningeal Melanomatosis
Introduction
Meningeal melanomatosis is a rare leptomeningeal tumor of melanotic cells that is characterized by slow and diffuse growth.1 The diagnosis of meningeal melanomatosis is challenging because the clinical symptoms and signs, as well as radiologic findings, are nonspecific. Therefore additional information gained via microscopy and immunohistochemical analysis is important for the correct diagnosis of meningeal melanomatosis. Here we report a case of diffuse meningeal melanocytosis diagnosed based on the pathohistologic findings biopsy.
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Case Report
A 21-year-old college student was admitted to our hospital after experiencing seizure and impaired memory for 5 months. In March 2018, he suddenly lost consciousness with tetanic seizure and was diagnosed with viral encephalitis according to normal results on cranial magnetic resonance imaging (MRI; Figure 1A and B) and lumbar puncture. Cranial MRI results showed that bilateral cerebral fissures were widened (see Figure 1C and D). His memory, learning ability, and academic performance continued
Discussion
Primary melanoma is rare, accounting for ≈0.06–0.1% of all central nervous system tumors.2 The diagnosis of primary melanoma is commonly made on the basis of cerebrospinal fluid cytology and/or pathologic examination of biopsied samples.3 Primary melanoma is commonly immunopositive for HMB-45 and S-1004 and has a Ki-67 percentage of ≤5%–10%, indicating low proliferation.5 In this case, black tissues with uniform distribution were observed after exposure of the dura mater during surgery. A rich
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Cited by (3)
Primary Meningeal Melanomatosis: ACase Report
2022, NeurographicsPrimary diffuse leptomeningeal melanomatosis: report of three pediatric cases and review of the literature
2021, Memo - Magazine of European Medical Oncology
Conflict of interest statement: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.