Pigmented lesions of the central nervous system: radiologic-pathologic correlation

Area of Science:

• Neurology
• Oncology
• Radiology

Background:

• Pigmented lesions of the central nervous system (CNS) encompass a spectrum of conditions, from benign to malignant.
• Their imaging characteristics are influenced by melanin content and hemorrhage, affecting lesion appearance.

Purpose of the Study:

• To review the diverse group of pigmented CNS lesions.
• To highlight the importance of differentiating primary melanocytic CNS lesions from metastatic melanoma.

Main Methods:

• Review of imaging characteristics and pathologic features of pigmented CNS lesions.
• Discussion of differential diagnosis considerations, including exclusion of occult primary melanoma.

Main Results:

• Pigmented lesions include primary melanocytic lesions (e.g., melanocytoma, melanoma) and metastatic melanoma.
• Other CNS neoplasms can undergo melanization (e.g., schwannoma, gliomas).
• Distinguishing primary from metastatic lesions is vital due to different management strategies.

Conclusions:

• Accurate identification of pigmented CNS lesions requires understanding their imaging and pathologic features.
• Excluding an occult primary melanoma is essential when a primary CNS lesion is suspected.