MR Imaging Findings of the Intraspinal Meningeal Melanocytoma: Correlation with Histopathologic Findings

Abstract

SUMMARY:Our aim was to better understand and improve the accuracy of the preoperative diagnosis of intraspinal MM by a combined analysis of MR imaging and pathologic findings. All 5 patients had undergone unenhanced and contrast-enhanced MR imaging examinations. All tumor samples had immunohistochemical reactions to HMB-45, vimentin, S-100, EMA, and Leu-7 antibodies. All 5 cases were located in the intradural extramedullary compartment. Two cases had multifocal lesions, and 3 cases were solitary. Two cases showed homogeneously strong enhancement, and 3 cases showed moderate enhancement on contrast-enhanced T1WI. The tumor cells had positive reactions to HMB-45, vimentin, and S-100 antibodies. MR imaging plays an important role in the detection and diagnosis of intraspinal MM. Final diagnosis should be based on histopathology and IHC examinations.ABBREVIATIONS: EMA ϭ epithelial membrane antigen; HMB-45 ϭ human melanoma black-45; IHC ϭ immunohistochemistry; MM ϭ meningeal melanocytoma P rimary melanocytic neoplasms of the CNS are lesions arising from melanocytes of the leptomeninges. Melanocytes are melanin-producing cells that derive from the neural crest during embryogenesis and then migrate to the skin, mucous membranes, and CNS.

Spinal meningeal melanocytoma in a 5-year-old child: a case report and review of literature

“…As for the radiological appearance, it correlates well with the available literature (Hou et al 2012 ; Alameda et al 1998 ). The signal intensity in different sequences depends mainly on the concentration of the melanin pigment in the tumor and so does the contrast enhancement.…”

“…For spinal meningeal melanocytoma (SMM), it is usually intradural extramedullary and to a lesser extent intramedullary (Of all 60 SMM, 40 cases were intradural extramedullary and 19 cases were intramedullary.) and this goes along with our case, with cervical levels being affected more than dorsal levels, and the lumbar levels were the least (Clarke et al 1998 ; Hou et al 2012 ; Alameda et al 1998 ; Eun et al 2011 ).…”

“…To the best of our knowledge after reviewing the literature, this is the youngest case to be reported (Clarke et al 1998 ). The usual age of presentation is usually around the fifth decade (Czarnecki et al 1997 ; Hou et al 2012 ), with age ranging from 9 to 79 years in different case reports reviewed (Shanthi et al 2010 ; Clarke et al 1998 ; Czarnecki et al 1997 ; Hou et al 2012 ; Alameda et al 1998 ). In the study of Yang et al ( 2016 ) (the largest case series in literature) which included 15 patients from the period of 2004–2014, the youngest patient was 14 years.…”

“…As for clinical presentation, our case had only a 4-month history of non-radiating low back pain with no radiculopathy or sphincter affection. In literature, the most common feature was radiculopathy, either pain or heaviness followed by back pain and sphincter affection (Czarnecki et al 1997 ; Hou et al 2012 ; Yang et al 2016 ; Dorwal et al 2014 ; Sen et al 2011 ).…”

Diagnostic Clue of Meningeal Melanocytoma: Case Report and Review of Literature

“…Electron microscopy demonstrates tumor cells with large nuclei with cytoplasmic melanin pigment and prominent nucleoli. 5 Mitotic activity is usually low, and necrosis is absent. By contrast, malignant melanomas present marked cellular and nuclear atypia, high mitotic activity, and necrosis.…”