Recurrent spinal meningeal melanocytoma at lumbar spine level: a case report

Intradural extramedullary meningeal melanocytoma: a case report and literature review

“…A preoperative differential of spinal meningeal melanocytomas is challenging due to their non-specific clinical and neurological presentations [ 5 ]. Clinical manifestations are usually progressive myelopathy and radiculopathy due to spinal cord and nerve root compression [ 6 ] as well as weakness, sensory deficits and progressive pain [ 5 ].…”

“…Radiologically, they appear as well-defined, extra-axial, isodense-to-hyperdense, homogeneous, contrast-enhancing mass lesions on CT. Their appearance is variable on MRI depending on melanin concentration [ 5 ]. MRI hyperintensity on T1-weighted imaging and iso-/hypointensity on T2-weighted imaging caused by melanin help to distinguish meningeal melanocytomas from other meningiomas [ 6 ].…”

“…Electron microscopy and immunoperoxidase staining are helpful in differentiating melanocytoma and meningioma [ 1 ]. On immunohistochemistry, meningeal melanocytomas are distinctively positive for HMB-45, S-100 protein and vimentin antibodies and are negative for EMA and Leu7 [ 6 ].…”

“…The risk of tumour recurrence is noted even after GTR; therefore, adjuvant radiotherapy is advised [ 5 ]. Meningeal melanocytomas are associated with leptomeningeal spread [ 5 ] and a high risk of local recurrence [ 6 ]. GTR is associated with better survival compared to subtotal resection (STR).…”

“…The mean age at which patients first presented was 40.6 years (5–72) [ 9 , 10 ]. Common presentations include leg weakness ( n = 8) [ 6 , 7 , 9 , 11–15 ], neck pain ( n = 5) [ 16–20 ] and back pain ( n = 4) [ 10 , 11 , 14 , 21 ]. The average duration of symptoms prior to initial presentation was 8.7 months (0.07–36); 43% ( n = 10) cases were in the cervical region, 43% ( n = 10) were in the thoracic region, 9% ( n = 2) were in the sacral region and 4% ( n = 1) were in the lumbar region of the spinal cord.…”