Meningeal melanocytoma: An aggressive course for a benign tumor

Ali Bydon, Jorge A. Gutierrez, Asim Mahmood

Research output: Contribution to journalArticle

Abstract

A 79-year-old female presented with difficulty ambulating and was found to have weakness and hyperreflexia in the lower extremities. Magnetic resonance imaging (MRI) revealed a large T8-T9 intraspinal tumor. She underwent a thoracic laminectomy, and excision of an intradural extramedullary lesion. The surgical specimen was soft, black tissue that consisted of a moderately cellular, deeply pigmented tumor. The neoplastic cells proved to be melanocytic, and were devoid of overt features of anaplasia, i.e., prominent nuclear pleomorphism, necrosis, significant mitotic activity, and high proliferation indices. Four months postoperatively, MRI demonstrated focal areas of enhancement in the conus medullaris and in the fourth ventricle, indicating leptomeningeal spread. Subsequently, the patient underwent whole brain radiation. On repeat imaging, there was nodular enhancement of the fourth ventricle and throughout the spinal cord. Despite chemotherapy and radiation therapy, the disease advanced and the patient expired. Meningeal melanocytoma is a rare, histologically benign tumor with good prognosis. However, local aggressive behavior has been recorded, especially in cases of subtotal gross resection. On a literature review, there was one case of cranial posterior fossa meningeal melanocytoma with associated lesions in both suprarenal glands and the left kidney, but there were no cases with distant metastasis. In this report, we present an unusual case of spinal meningeal melanocytoma with diffuse spread throughout the craniospinal axis that proved to be fatal.

Original languageEnglish (US)
Pages (from-to)259-263
Number of pages5
JournalJournal of Neuro-Oncology
Volume64
Issue number3
DOIs
StatePublished - Sep 2003
Externally publishedYes

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Fourth Ventricle
Spinal Cord
Anaplasia
Magnetic Resonance Imaging
Posterior Cranial Fossa
Abnormal Reflexes
Neoplasms
Laminectomy
Lower Extremity
Necrosis
Radiotherapy
Thorax
Radiation
Neoplasm Metastasis
Kidney
Drug Therapy
Brain

Keywords

  • CNS tumors
  • Histologically benign tumors
  • Leptomeningeal tumors
  • Meningeal melanocytoma
  • Pigmented neoplasms

ASJC Scopus subject areas

  • Clinical Neurology
  • Cancer Research
  • Oncology
  • Neuroscience(all)

Cite this

Meningeal melanocytoma : An aggressive course for a benign tumor. / Bydon, Ali; Gutierrez, Jorge A.; Mahmood, Asim.

In: Journal of Neuro-Oncology, Vol. 64, No. 3, 09.2003, p. 259-263.

Research output: Contribution to journalArticle

Bydon, Ali ; Gutierrez, Jorge A. ; Mahmood, Asim. / Meningeal melanocytoma : An aggressive course for a benign tumor. In: Journal of Neuro-Oncology. 2003 ; Vol. 64, No. 3. pp. 259-263.
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