Meningeal melanocytoma of the posterior fossa: case report and literature review.

Walter J Fagundes-Pereyra, Larissa de Sousa, Gervásio Teles Cardoso Carvalho, José Eydmar Homem Pittella, Atos Alves de Sousa

Journal: Surgical neurology 2005;63(3):269-73; discussion 273-4

PMID: 15734524

Abstract

BACKGROUND

Meningeal melanocytomas are rare primary melanotic tumors of the leptomeninges. According to our review of the literature, just 22 cases of meningeal melanocytoma (MM) of the posterior fossa have been previously reported. Some aspects related to diagnosis, radiological appearance, histopathologic features, and management are discussed in this paper.

CASE DESCRIPTION

We describe the case of a 42-year-old female presenting with severe headache, nausea, and vomiting. Computed tomography and magnetic resonance imaging demonstrated a posterior fossa lesion that was surgically treated. Histopathologic examination showed a highly cellular melanocytic neoplasm with numerous dark pigments in the cytoplasm. Immunoperoxidase staining S-100 protein and HMB 45 demonstrated immunoreactivity for both, confirming the diagnosis of MM.

CONCLUSIONS

In conclusion, MMs are rare histologically benign tumors that can be cured by complete surgical resection alone, which should be the goal of the treatment. These lesions, although rare, should be considered in the differential diagnosis of tumors of the posterior fossa.

Address: Department of Neurosurgery, Santa Casa Hospital at Belo Horizonte, School of Medical Science of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. [email protected]

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