Spinal meningeal melanocytoma in a 5-year-old child: a case report and review of literature

Abstract

BackgroundMeningeal melanocytoma is considered a rare lesion arising from leptomeningeal melanocytes. Nearly two thirds of meningeal melanocytomas were reported in the intracranial compartment and the remaining one third in the spine. Spinal melanocytomas can be extradural or intradural, with extradural variant being more common, and the majority of cases have been single reports.MethodsA 5-year-old male presented with a 4-month history of non-radiating low back pain persistent at rest, with otherwise non-remarkable medical history. The patient was neurologically intact with no deficits. Preoperatively, routine laboratory investigations were non-remarkable. MRI imaging was done and showed a lesion at the level of T11 to L4, hyperintense on T1 and hypointense on T2 with homogenous contrast enhancement. Intraoperatively, the lesion was hemorrhagic, brownish, and rubbery in consistency attached to the ventral dura. Microscopic picture revealed dense cytoplasmic brown melanin pigments, with no significant mitoses or nuclear atypia. What is unique about our case is the age of the patient (5 years).ResultsTo the best of our knowledge, after reviewing the literature, this is the youngest case to be reported.ConclusionsSMM is an extremely rare tumor with a benign course. Complete surgical excision should be attempted. Age of presentation may be as young as in our case and the diagnosis of such a tumor should never be excluded in this early age group with persistent low back ache.

Intradural extramedullary meningeal melanocytoma: a case report and literature review

“…Twenty-three patients were identified, who were predominantly males ( n = 17). 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 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.…”

“…The remaining patients (43%, n = 10) underwent STR, with the extent of resection determined by the surgeon; 43% ( n = 10) of patients experienced complete resolution of their symptoms after surgery. Post-operative complications were infrequently reported, however, the most reported was genitourinary dysfunction ( n = 5) [ 6 , 10 , 14 , 22 , 23 ]. Four patients were not followed up, but of those that were, the average follow-up period was 16 months (1–96).…”

Primary intramedullary melanocytoma presenting with lower limbs, defecation, and erectile dysfunction: A case report and review of the literature

“…The designation “meningeal melanocytoma” in the primary melanocytic tumors of the CNS was confirmed for the first time in 1972, which frequently tended to occur in the veutro of medulla or the upper segments of the spinal cord, but the term “melanocytoma” defining the subtype of neoplasms was adopted by the WHO classification[ 1 , 4 ]. The age of onset ranged from 5 years to 79 years with a peak around the fifth decade[ 5 ]. The ratio of male to female was 2.2:1, and the tumors are mainly located at the level of cervical vertebra[ 6 ].…”