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Primary diffuse meningeal melanomatosis: radiologic-pathologic correlation.

Maria-Giulia Pirini1, Mario Mascalchi, Fabrizio Salvi

  • 1Pathology Unit of the Addarii Institute of Oncology, Policlinico S. Orsola-Malpighi, the University of Bologna, Italy.

AJNR. American Journal of Neuroradiology
|January 21, 2003
PubMed
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Primary diffuse meningeal melanomatosis, a rare CNS melanoma variant, was diagnosed post-mortem in a 68-year-old woman. Imaging revealed nonspecific findings mimicking intracranial hypotension, highlighting diagnostic challenges for this extensive leptomeningeal invasion.

Area of Science:

  • Neurology
  • Oncology
  • Radiology

Background:

  • Primary diffuse meningeal melanomatosis is a rare malignant melanoma variant affecting the central nervous system (CNS).
  • This condition often presents with nonspecific symptoms, potentially mimicking other neurological disorders.

Observation:

  • A 68-year-old woman presented with symptoms suggestive of intracranial hypotension syndrome.
  • Computed Tomography (CT) showed hydrocephalus and abnormal contrast enhancement in specific fissures.
  • Magnetic Resonance (MR) imaging revealed diffuse dural and leptomeningeal contrast enhancement.

Findings:

  • The patient's condition was diagnosed definitively at autopsy.
  • Autopsy confirmed extensive leptomeningeal invasion throughout the cerebral hemispheres, brain stem, and spinal cord.

Related Experiment Videos

  • Cerebrospinal fluid (CSF) cytology results were negative, complicating antemortem diagnosis.

    • Implications:

    • This case underscores the diagnostic challenges posed by primary diffuse meningeal melanomatosis.
    • Radiologic findings, though nonspecific, can correlate with extensive leptomeningeal disease.
    • Reviewing clinical, radiologic, and pathologic features is crucial for understanding this rare CNS malignancy.