Primary Intracranial Leptomeningeal Melanomatosis

Kim, Dohyoung; Choi, Chan-Young; Lee, Chae-Heuck; Joo, Mee

doi:10.3340/jkns.2015.58.6.554

Cited by 16 publications

(10 citation statements)

References 8 publications

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“…Although diagnosis of primary CNS melanomas without biopsy is challenging, aggressive subarachnoid space invasion in meningeal melanomatosis may raise the odds of the presence of malignant cells in the CSF. In some human cases, as well as in our case, malignant melanocytes were observed in the CSF [3,9,15]. Although the probability of detecting malignant melanocytes in the CSF remains unclear in human literature, repeating CSF tap may be beneficial, since the first tap could only reveal elevated protein and pleocytosis without neoplastic cells, even when lesions were found on MRI [3,9].…”

supporting

confidence: 49%

Diagnosis of meningeal melanomatosis in a dog using magnetic resonance imaging and cerebrospinal fluid findings

Huang

Liao

et al. 2021

The Journal of Veterinary Medical Science

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A 13-year-old spayed female Labrador Retriever was presented with severe progressive tetraparesis. The neuroanatomic localization was the C1-C5 spinal cord segments with brainstem or cranial nerve involvement. Magnetic resonance imaging revealed diffuse T1weighted and T2-weighted hyperintense lesions with strong contrast enhancement spreading through meninges of the cervical spinal cord and the brain. Few small round areas showing T1weighted hyperintensity and T2-weighted hypointensity were scattered within the lesions. Cerebrospinal fluid analysis revealed neoplastic round cells and possible melanocytes. Malignant melanoma was suspected. At necropsy, the brain and the entire spinal cord were covered with thick, dark membranous tissue. Based on histopathologic findings, a positive response against Melan-A, and no melanoma identified outside the central nervous system, primary meningeal melanomatosis was diagnosed.

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supporting

confidence: 49%

Diagnosis of meningeal melanomatosis in a dog using magnetic resonance imaging and cerebrospinal fluid findings

Huang

Liao

et al. 2021

The Journal of Veterinary Medical Science

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“…Primary diffuse leptomeningeal melanomatosis (melanocytosis) is an extremely rare tumour, with the related literature primarily consisting of individual case reports. [2][3][4][5] Melanocytic lesions involving the CNS include both benign (leptomeningeal melanocytosis, melanocytoma) and malignant (leptomeningeal melanomatosis, melanoma) pathologies. 6 The signs and symptoms of these pathologies depend on the site of anatomical involvement (cerebral hemispheres, cranial nerves, spinal cord and nerve roots).…”

Section: Discussionmentioning

confidence: 99%

“…12 Most authors quote a median survival of less than one year. 3,4,11 Vemurafenib is a BRAF inhibitor that has demonstrated dramatic activity in BRAF V600E-mutated melanoma. There is a report of a patient who had melanoma with leptomeningeal melanomatosis, describing that the patient had remarkable clinical and radiological improvement after the initiation of vemurafenib.…”

Section: Discussionmentioning

confidence: 99%

Two cases of primary leptomeningeal melanomatosis mimicking subacute meningitis

et al. 2017

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Primary involvement of leptomeninges with melanocytic tumours is rarely seen and its diagnosis is challenging. Here we summarise two cases of primary leptomeningeal melanomatosis presenting as subacute meningitis. Both cases have pleocytosis and high protein on cerebrospinal fluid analysis, and demonstrated atypical cells on cytology. On magnetic resonance imaging, there is diffuse leptomeningal thickening and avid enhancement of intracranial and intraspinal leptomeninges. One of them demonstrates T1 shortening due to magnetic effects of melanin, the other case is amelanotic and shows hypointensity on precontrast T1-weighted images. Both cases can be diagnosed with biopsy. In conclusion, these cases highlight the importance of the correct interpretation of cytological and magnetic resonance imaging findings in patients with atypical findings.

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“…In 1976, Hayward proposed this classification: (1) primary brain malignant melanoma, (2) secondary brain malignant melanoma, and (3) other brain tumors with melanin [ 17 ]. He described the primary CNS melanoma when there are (1) no malignant melanoma outside CNS, (2) absences of this lesion in other part of CNS, and (3) histological confirmations of melanoma [ 8 ]. Since then, no other criteria have been developed [ 18 ] probably because the low incidences of primary CNS melanoma.…”

Section: Case Presentationmentioning

confidence: 99%

“…Total excision of brain melanoma is the mainstay of the treatment in most cases [ 4 – 6 ]. Skin melanomas have an aggressive behavior and tend to metastasize to other organs [ 7 ]; nevertheless, extracerebral metastasis from primary brain melanoma is extremely rare [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Primary cerebral malignant melanoma in insular region with extracranial metastasis: case report and review literature

et al. 2016

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BackgroundPrimary brain melanomas are very infrequent and metastasis outside central nervous system very uncommon. There are some cases in the literature about primary melanoma in the temporal lobe; nevertheless, the insular location has never been described.Case presentationThe patient presented as left insular intraparenchymal hematoma with multiple bleedings. Complementary tests did not show any tumoral nor vascular pattern in relation with these bleedings. A complete surgical resection was performed, and the diagnosis of malignant melanoma, with BRAF mutation, was obtained after histology exam. Extension studies were negative for skin or mucous melanoma. 18F-FDG PET/CT was performed and a metastatic lymph node was found. The diagnosis was primary brain melanoma with extracerebral metastasis. Dabrafenib 150 mg/12 h was the only chemotherapy during 5 months. After that, Trametinib 2 mg/24 h was added to the treatment. Eighteen months after surgery, the patient is independent, with stable situation, and without new metastasis.ConclusionsAlthough malignant melanomas have poor prognosis, total surgical resection and new therapies are increasing the overall survival and improving quality of life. In a patient with suspected brain melanoma, in spite of having extracerebral metastasis, aggressive treatment may be considered.

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Primary Intracranial Leptomeningeal Melanomatosis

Cited by 16 publications

References 8 publications

Diagnosis of meningeal melanomatosis in a dog using magnetic resonance imaging and cerebrospinal fluid findings

Diagnosis of meningeal melanomatosis in a dog using magnetic resonance imaging and cerebrospinal fluid findings

Two cases of primary leptomeningeal melanomatosis mimicking subacute meningitis

Primary cerebral malignant melanoma in insular region with extracranial metastasis: case report and review literature

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