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CC BY-NC-ND 4.0 · Asian J Neurosurg 2021; 16(01): 159-163
DOI: 10.4103/ajns.AJNS_327_20
Case Report

Recurrent meningeal melanocytoma of cervical spine: A rare case

Mihir Vaidya
Department of Histopathology, Sahyadri Speciality Hospital, Pune, Maharashtra
,
Rahul Dhake
Department of Histopathology, Sahyadri Speciality Hospital, Pune, Maharashtra
,
Rashmi Parikh
Department of Histopathology, Sahyadri Speciality Hospital, Pune, Maharashtra
,
Manish Sabnis
1   Department of Neurosurgery, Sahyadri Speciality Hospital, Pune, Maharashtra
,
Josna Sabnis
1   Department of Neurosurgery, Sahyadri Speciality Hospital, Pune, Maharashtra
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Melanocytomas of the central nervous system are rare benign or intermediate grade localized melanocytic tumors. Despite its benign nature, it can follow a locally aggressive course with propensity to recur. We present the case of a 29 years old female who presented with a recurrent lesion in cervical spine and rapidly progressing quadriparesis. On examination, there was loss of power in right-sided extremities and reduction in sensations in left-sided extremities. Magnetic resonance imaging spine revealed a homogeneously enhancing intradural extramedullary dumbbell-shaped mass lesion at C4/5 level with extension through right C4 neural foramina to the extraforamina space, causing severe spinal cord compression. Intraoperatively, bluish-colored tumor was identified along with underlying hematoma. Gross total excision of the tumor was done. Tumor was received in the histopathology department in multiple black-colored fragments. Microscopically, a heavily pigmented tumor was seen with the sheets and nodules of polygonal cells with large nuclei and prominent nucleoli. Differentials considered were meningeal melanocytoma and malignant melanoma. On immunohistochemistry, the tumor cells showed diffuse positivity for HMB 45 and S100. Ki 67 index was around 1%. On radiological review, the tumor was fairly well circumscribed and did not infiltrate the adjacent tissues. There was no evidence of any lesions elsewhere in the body. Considering these features, the tumor was diagnosed with meningeal melanocytoma. Postoperatively, there was significant immediate improvement in quadriparesis and patient could walk with minimal support.

Key-words:

Cervical spine - HMB45 - melanocytoma - melanoma - pigmented schwannoma

Financial support and sponsorship

Nil.




Publication History

Received: 09 July 2020

Accepted: 27 October 2020

Article published online:
16 August 2022

© 2021. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Louis DN, Ohgaki H, Wiestler OD, Cavenee WK. WHO Classification of Tumours of the Central Nervous System. 4th ed. Lyon: International Agency for Research on Cancer: 2016.
  • 2 Jellinger K, Böck F, Brenner H. Meningeal melanocytoma report of a case and review of the literature. Acta Neurochir (Wien) 1988;94:78-87.
  • 3 Wagner F, Berezowska S, Wiest R, Gralla J, Beck J, Verma RK, et al. Primary intramedullary melanocytoma in the cervical spinal cord: Case report and literature review. Radiol Case Rep 2015;10:1010.
  • 4 Brat DJ, Giannini C, Scheithauer BW, Burger PC. Primary melanocytic neoplasms of the central nervous system. Am J Surg Pathol 1999;23:745-54.
  • 5 Wang H, Zhang S, Wu C, Zhang Z, Qin T. Melanocytomas of the central nervous system: A clinicopathological and molecular study. Eur J Clin Invest 2013;43:809-15.
  • 6 Liubinas SV, Maartens N, Drummond KJ. Primary melanocytic neoplasms of the central nervous system. J Clin Neurosci 2010;17:1227-32.
  • 7 Kadonaga JN, Frieden IJ. Neurocutaneous melanosis: Definition and review of the literature. J Am Acad Dermatol 1991;24:747-55.
  • 8 Chang CS, Hsieh PF, Chia LG, Chen CC, Chen CC, Pan ST, et al. Leptomeningeal malignant melanoma arising in neurocutaneous melanocytosis: A case report. Zhonghua Yi Xue Za Zhi (Taipei) 1997;60:316-20.
  • 9 Prabhu SS, Lynch PG, Keogh AJ, Parekh HC. Intracranial meningeal melanocytoma: A report of two cases and a review of the literature. Surg Neurol 1993;40:516-21.
  • 10 Maiuri F, Iaconetta G, Benvenuti D, Lamaida E, De Caro ML. Intracranial meningeal melanocytoma: Case report. Surg Neurol 1995;44:556-61.
  • 11 Uematsu Y, Yukawa S, Yokote H, Itakura T, Hayashi S, Komai N. Meningeal melanocytoma: Magnetic resonance imaging characteristics and pathological features: Case report. J Neurosurg 1992;76:705-9.
  • 12 Naul LG, Hise JH, Bauserman SC, Todd FD. CT and MR of meningeal melanocytoma. Am J Neuroradiol 1991;12:315-6.
  • 13 Sen R, Sethi D, Goyal V, Duhan A, Modi S. Spinal meningeal melanocytoma. Asian J Neurosurg 2011;6:110-2.
  • 14 Litofsky NS, Zee CS, Breeze RE, Chandrasoma PT. Meningeal melanocytoma: Diagnostic criteria for a rare lesion. Neurosurgery 1992;31:945-8.
  • 15 Smith AB, Rushing EJ, Smirniotopoulos JG. Pigmented lesions of the central nervous system: Radiologic-pathologic correlation. Radiographics 2009;29:1503-24.
  • 16 Navas M, Pascual JM, Fraga J, Pedrosa M, Shakur S, Carrasco R, et al. Intracranial intermediate-grade meningeal melanocytoma with increased cellular proliferative index: An illustrative case associated with a nevus of Ota. J Neurooncol 2009;95:105-15.
  • 17 Lin B, Yang H, Qu L, Li Y, Yu J. Primary meningeal melanocytoma of the anterior cranial fossa: A case report and review of the literature. World J Surg Oncol 2012;10:135.
  • 18 Rades D, Tatagiba M, Brandis A, Dubben HH, Karstens JH. The value of radiotherapy for the treatment of meningeal melanocytoma. Strahlenther Onkol 2002;178:336-42.
  • 19 Rades D, Heidenreich F, Tatagiba M, Brandis A, Karstens JH. Therapeutic options for meningeal melanocytoma. J Neurosurg 2001;95:225-31.
  • 20 Rades D, Schild SE, Tatagiba M, Molina HA, Alberti W. Therapy of meningeal melanocytomas. Cancer 2004;100:2442-7.
  • 21 Bydon A, Gutierrez JA, Mahmood A. Meningeal melanocytoma: An aggressive course for a benign tumor. J Neurooncol 2003;64:259-63.
  • 22 Roser F, Nakamura M, Brandis A, Hans V, Vorkapic P, Samii M. Transition from meningeal melanocytoma to primary cerebral melanoma: Case report. J Neurosurg 2004;101:528-31.
  • 23 Wang F, Li X, Chen L, Pu X. Malignant transformation of spinal meningeal melanocytoma: Case report and review of the literature. J Neurosurg Spine 2007;6:451-4.