Neurocutaneous Melanosis Presenting As an Intradural Mass of the Cervical Canal

Abstract

We present a case of neurocutaneous melanosis in a 1-year-old child who presented with progressive quadriparesis created by an infiltrating extra-axial neoplastic melanin-producing tumor at the foramen magnum. This extensive intra-arachnoid mass filled the basal cisterns of the brain and surrounded the upper cervical cord. An imaging clue to the diagnosis was apparent as T1-weighted shortening on magnetic resonance in the pia and/or cortex of the cerebellar folia, suggesting the presence of melanin.

Primary melanocytic neoplasms of the central nervous system

“…Brain parenchymal invasion indicates malignant change to melanomatosis. 2,17,47 Melanocytomas are solitary low grade lesions that do not invade the surrounding brain parenchyma. Abnormal mitoses and atypical cytology are generally absent.…”

“…14,18 There is no definitive treatment and palliation consists of tumour debulking and placement of a ventricular shunt. 2,12,14,17,47 A filter should be placed on the shunt to prevent seeding. 27,61,62…”