Primary malignant melanoma of the meninges is an exceedingly rare neoplasm. Usually its symptoms
include raised intracraneal pressure resulting from hydrocephalus seconday to tumoral obliteration of
cisternal basal cisterns, but the passage of time from initial symptomalogy to diagnosis is frequently delayed.
A 12-year-old male with primary letomeningeal melanoma is reported. At the beginning, he presented with
vomiting, headache, complex seizures, fever four months before the admission in the hospital where
progressive loss of consciouness after admission. Lumbar puncture reveled high protein level, normal
glucose level and 50 leucocytes/mm3 with 86% polymorphic cells. Magnetic ressonance imaging of the
brain was referred and in T1-weighted images revealed a diffuse enhancement of the leptomeninges on right
frontal cortical. An open brain biopsy trough was performed, after exclusion of the infectious nervous
system disease. Histological examination revealed massive infiltration of meninges with brown tumor cells.
These cells stained positive for HMB-45, S-100 protein and vimentin. The patient received post operative
radiation therapy, but died after three months of the diagnosis with septic shock and epileptical status