ABSTRACT
Primary intracranial melanomas are rare, especially in the primary cerebellopontine
angle. We describe a patient with a presumed jugular foramen meningioma that was found
to be of melanotic origin at surgery. We followed this 26-year-old woman with mild
ataxia with serial imaging for 18 months after the initial discovery of a cerebellopontine
angle extra-axial mass. She developed worsening symptoms of ataxia, dysphagia, and
right-sided hearing loss. Magnetic resonance imaging showed an interval increase in
size of the mass. The lesion was thought to be a meningioma with a dural tail that
extended into the jugular foramen and hypoglossal canal. She underwent preoperative
angiography and attempted tumor embolization, followed by resection via a transcochlear
infratemporal approach. At surgery the lesion was found to be heavily pigmented. Pathological
analysis was consistent with a low-grade melanoma. No primary extracranial site was
identified. One year after surgery the patient remains free of systemic disease or
recurrence.
KEYWORDS
Cerebellopontine angle - melanoma - melanocytoma