Primary solitary intracranial melanoma in the sylvian fissure: MR demonstration

Kashiwagi, Nobuo; Hirabuki, Norio; Morino, Hideo; Taki, Takuyu; Yoshida, Wakako; Nakamura, Hajime

doi:10.1007/s00330-002-1372-8

Cited by 15 publications

(7 citation statements)

References 10 publications

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“…3,4,16,21,27,37,38,41 The hallmark histologic features of PLM include positive immunohistochemical staining for HMB-45, S-100 protein, and vimentin as well as negative testing for glial fibrillary acid protein (GFAP) and epithelial membrane antigen 42 that exclude a glial origin and meningioma. 2,7,9,10,23 In the present case, histology revealed a cellular neoplasm with moderately polymorphic cells with prominent nucleoli and focal deposition of brown pigment. Scattered mitoses were detectable (►Fig.…”

Section: Pathologymentioning

confidence: 46%

“…It should be noted that intermediate grades of melanocytic tumors do exist. 5,7,9,23,31,43 The absence of an additional tumor source in conjunction with the pathologic findings just described led to the diagnosis of a solitary PLM in this patient. 44…”

Section: Pathologymentioning

confidence: 58%

“…2,18 Communicating hydrocephalus with associated intracranial hypertension seem to be common clinical features of melanocytic lesions in the CNS. 2,3,9,15,[19][20][21][22] Although the cause remains unclear, intracranial hypertension with communicating hydrocephalus can be the first and only clinical sign of PLM. 15,23 Communicating hydrocephalus in the setting of diffuse leptomeningeal melanosis can be explained by features of poor CSF resorption.…”

Section: Clinical Evaluationmentioning

confidence: 99%

“…The radiographic diagnosis of PLM can be problematic. 9,14,17,18,27,33,36,37 The paramagnetic properties of melanin create hyperintense signal on T1-weighted images and isointense signal on T2-weighted images, which can be interpreted as intratumoral hemorrhage. 2,3,15,17,27 PLM and other melanocytic lesions tend to enhance avidly with gadolinium.…”

Section: Radiologymentioning

confidence: 99%

“…melanocytoma and meningioma) that can be mimicked by PLM. [5][6][7][8][9][10][11][12][13] Meningioma is one of the most common neurosurgical conditions, constituting > 20% of primary brain tumors. 6 Spinal PLM represents both diagnostic and management challenges.…”

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confidence: 99%

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Primary Leptomeningeal Melanoma of the Cervical Spine Mimicking a Meningioma—A Case Report

et al. 2014

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Background and Importance Primary leptomeningeal melanoma (PLM) is highly malignant and exceedingly rare. Due to its rarity, diagnostic and treatment paradigms have been slow to evolve. We report the first case of a PLM that mimics a cervical spine meningioma and then discuss the current clinical, radiologic, and pathologic diagnostic methodologies as well as expected outcomes related to this disease. Clinical Presentation A 54-year-old woman presented a dural-based extramedullary solid mass ventral to the C2–C3 spinal cord causing spinal cord compression without cord signal changes, characteristic of meningioma. Intraoperative microscopic inspection revealed numerous black spots littering the surface of the dura; the tumor itself was yellow in appearance and had a soft consistency. Pathologic analysis of the specimen revealed a malignant melanin-containing tumor. No primary site was found, so a diagnosis of primary leptomeningeal melanoma was made, and the patient subsequently received interferon therapy. To date (2 years postoperatively), no local or systemic recurrence of the tumor has been identified. Conclusion As with most rare tumors, case reports constitute the vast majority of references to PLM. Only an increased awareness and an extensive report of each individual case can help diagnose and clarify the nature of PLM. Clinicians need to be aware of such malignant conditions when diagnosing benign tumoral lesions of the spine such as meningiomas.

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