Download PDF
J Neurol Surg Rep 2012; 73(01): 025-031
DOI: 10.1055/s-0032-1311756
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Primary Cerebellopontine Angle Melanocytoma: Review

Isaac Phang
1   Department of Neurosurgery, Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom
,
Rahim Elashaal
1   Department of Neurosurgery, Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom
,
James Ironside
2   Department of Neuropathology, Western General Hospital, Edinburgh, Scotland, United Kingdom
,
Sam Eljamel
1   Department of Neurosurgery, Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom
› Author Affiliations
Further Information

Publication History

30 June 2011

05 December 2011

Publication Date:
20 April 2012 (online)

   Permissions and Reprints

Abstract

Introduction Primary cerebellopontine angle melanocytomas (PCPAMs) are very rare. Their natural history and prognosis are not fully understood. We reviewed the literature and add a new case to analyze PCPAM's presentation, radiological features, and outcome of treatment.

Methods We performed a literature review using Medline, Embase, PubMed, and Cochrane databases. We searched for melanocytoma, melanoma, and pigmented tumors in the posterior cranial fossa and CPA to identify PCPAM. We have also searched our institution's neuro-oncology database.

Results We identified 23 PCPAM from the literature and one case of our own. The mean age at presentation was 44.4 years with slight male preponderance. PCPAM presented with cerebellopontine angle (CPA) syndrome with or without hydrocephalus. Preoperative diagnosis was difficult; they appeared hyperintense on T1 and isointense on T2 magnetic resonance imaging (MRI) and enhanced with gadolinium. However, the final diagnosis was only made by immunohistochemical examination. Total surgical resection of PCPAM was associated with prolonged survival while subtotal excision was associated with frequent recurrence.

Conclusion PCPAM are very rare and should be considered in the differential diagnosis of all CPA lesions that appear hyperintense on T1 and isointense on T2 MRI images. Patients with PCPAM should undergo total surgical resection to avoid fatal recurrences.

Keywords

CPA - melanocytoma - pigmented tumors
 

  • References

  • 1 Keegan HR, Mullan S. Pigmented meningiomas: an unusual variant. Report of a case with review of the litera ure. J Neurosurg 1962; 19: 696-698
    PubMedGoogle Scholar
  • 2 Limas C, Tio FO. Meningeal melanocytoma (“melanotic meningioma”). Its melanocytic origin as revealed by electron microscopy. Cancer 1972; 30 (5) 1286-1294
    CrossrefPubMedGoogle Scholar
  • 3 Portugal JR, Alencar A, Brito Lira LC, Carvalho P. Melanotic meningioma complicated by disseminated intravascular coagulation. Surg Neurol 1984; 21 (3) 275-281
    CrossrefPubMedGoogle Scholar
  • 4 Lesoin F, Leys D, Pasquier F , et al. Melanotic meningiomas. Report of a case and review of the literature. Neurochir 1985; 28 (5) 205-207
    PubMedGoogle Scholar
  • 5 Winston KR, Sotrel A, Schnitt SJ. Meningeal melanocytoma. Case report and review of the clinical and histological features. J Neurosurg 1987; 66 (1) 50-57
    CrossrefPubMedGoogle Scholar
  • 6 Naul LG, Hise JH, Bauserman SC, Todd FDCT. CT and MR of meningeal melanocytoma. AJNR Am J Neuroradiol 1991; 12 (2) 315-316
    PubMedGoogle Scholar
  • 7 Litofsky NS, Zee CS, Breeze RE, Chandrasoma PT. Meningeal melanocytoma: diagnostic criteria for a rare lesion. Neurosurgery 1992; 31 (5) 945-948
    CrossrefPubMedGoogle Scholar
  • 8 Uematsu Y, Yukawa S, Yokote H, Itakura T, Hayashi S, Komai N. Meningeal melanocytoma: magnetic resonance imaging characteristics and pathological features. Case report. J Neurosurg 1992; 76 (4) 705-709
    CrossrefPubMedGoogle Scholar
  • 9 Brat DJ, Giannini C, Scheithauer BW, Burger PC. Primary melanocytic neoplasms of the central nervous systems. Am J Surg Pathol 1999; 23 (7) 745-754
    Google Scholar
  • 10 Gupta A, Ahmad FU, Sharma MC, Garg A, Mehta VS. Cerebellopontine angle meningeal melanocytoma: a rare tumor in an uncommon location. Case report. J Neurosurg 2007; 106 (6) 1094-1097
    CrossrefPubMedGoogle Scholar
  • 11 O'Brien TF, Moran M, Miller JH, Hensley SD. Meningeal melanocytoma. An uncommon diagnostic pitfall in surgical neuropathology. Arch Pathol Lab Med 1995; 119 (6) 542-546
    PubMedGoogle Scholar
  • 12 Tatagiba M, Böker DK, Brandis A, Samii M, Ostertag H, Babu R. Meningeal melanocytoma of the C8 nerve root: case report. Neurosurgery 1992; 31 (5) 958-961
    CrossrefPubMedGoogle Scholar
  • 13 Nestor SL, Perry A, Kurtkaya O , et al. Melanocytic colonization of a meningothelial meningioma: histopathological and ultrastructural findings with immunohistochemical and genetic correlation: case report. Neurosurgery 2003; 53 (1) 211-214 , discussion 214–215
    CrossrefPubMedGoogle Scholar
  • 14 Gardiman M, Altavilla G, Marchioro L, Boscolo L, Alessio L, Piazza M. Meningeal melanocytoma: a rare lesion of the central nervous system. Tumori 1996; 82 (5) 494-496
    PubMedGoogle Scholar
  • 15 Hirose T, Horiguchi H, Kaneko F , et al. Melanocytoma of the foramen magnum. Pathol Int 1997; 47 (2–3) 155-160
    CrossrefPubMedGoogle Scholar
  • 16 Clarke DB, Leblanc R, Bertrand G, Quartey GRC, Snipes GJ. Meningeal melanocytoma. Report of a case and a historical comparison. J Neurosurg 1998; 88 (1) 116-121
    CrossrefPubMedGoogle Scholar
  • 17 Ahluwalia S, Ashkan K, Casey AT. Meningeal melanocytoma: clinical features and review of the literature. Br J Neurosurg 2003; 17 (4) 347-351
    CrossrefPubMedGoogle Scholar
  • 18 Kan P, Shelton C, Townsend J, Jensen R. Primary malignant cerebellopontine angle melanoma presenting as meningioma: case report and review of the literature. Skull Base 2003; 13 (3) 159-166
    Article in Thieme ConnectPubMedGoogle Scholar
  • 19 Fagundes-Pereyra WJ, de Sousa L, Carvalho GT, Pittella JE, de Sousa AA. Meningeal melanocytoma of the posterior fossa: case report and literature review. Surg Neurol 2005; 63 (3) 269-273 , discussion 273–274
    CrossrefPubMedGoogle Scholar
  • 20 Koenigsmann M, Jautzke G, Unger M, Théallier-Janko A, Wiegel T, Stoltenburg-Didinger G. June 2002: 57-year-old male with leptomeningeal and liver tumors. Brain Pathol 2002; 12 (4) 519-521
    PubMedGoogle Scholar
  • 21 Córdoba A, Tuñón T, Vázquez JJ. [Meningeal melanocytoma. Presentation of a case and review of the literature]. Arch Neurobiol (Madr) 1989; 52 (2) 93-99
    PubMedGoogle Scholar
  • 22 Rades D, Heidenreich F, Tatagiba M, Brandis A, Karstens JH. Therapeutic options for meningeal melanocytoma. Case report. J Neurosurg 2001; 95 (2, Suppl) 225-231
    CrossrefPubMedGoogle Scholar
  • 23 Bydon A, Gutierrez JA, Mahmood A. Meningeal melanocytoma: an aggressive course for a benign tumor. J Neurooncol 2003; 64 (3) 259-263
    CrossrefPubMedGoogle Scholar
  • 24 Ali Y, Rahme R, Moussa R, Abadjian G, Menassa-Moussa L, Samaha E. Multifocal meningeal melanocytoma: a new pathological entity or the result of leptomeningeal seeding?. J Neurosurg 2009; 111 (3) 488-491
    CrossrefPubMedGoogle Scholar
  • 25 Prabhu SS, Lynch PG, Keogh AJ, Parekh HC. Intracranial meningeal melanocytoma: a report of two cases and a review of the literature. Surg Neurol 1993; 40 (6) 516-521
    CrossrefPubMedGoogle Scholar
  • 26 Chow M, Clarke DB, Maloney WJ, Sangalang V. Meningeal melanocytoma of the planum sphenoidale. Case report and review of the literature. J Neurosurg 2001; 94 (5) 841-845
    CrossrefPubMedGoogle Scholar
  • 27 Maiuri F, Iaconetta G, Benvenuti D, Lamaida E, De Caro ML. Intracranial meningeal melanocytoma: case report. Surg Neurol 1995; 44 (6) 556-561
    CrossrefPubMedGoogle Scholar
  • 28 Hamasaki O, Nakahara T, Sakamoto S, Kutsuna M, Sakoda K. Intracranial meningeal melanocytoma. Neurol Med Chir (Tokyo) 2002; 42 (11) 504-509 (Tokyo)
    CrossrefPubMedGoogle Scholar
  • 29 Kurita H, Segawa H, Shin M , et al. Radiosurgery of meningeal melanocytoma. J Neurooncol 2000; 46 (1) 57-61
    CrossrefPubMedGoogle Scholar
  • 30 Verma DS, Spitzer G, Legha S, McCredie KB. Chemoimmunotherapy for meningeal melanocytoma of the thoracic spinal cord. Report of a case. JAMA 1979; 242 (22) 2435-2436
    CrossrefPubMedGoogle Scholar