Spinal meningeal melanocytoma

Area of Science:

• Neuro-oncology
• Pathology
• Neurosurgery

Background:

• Primary melanotic meningeal neoplasms are exceptionally rare, with benign variants being even rarer.
• Benign meningeal melanocytomas offer a better prognosis compared to their malignant counterparts.

Observation:

• A 40-year-old male presented with progressive bilateral lower limb weakness.
• Radiological investigations revealed an intradural mass measuring 1.5x1.0 cm.
• The mass was surgically excised.

Findings:

• Histopathology showed heavily melanin-pigmented cells with specific nuclear and cytoplasmic features, suggesting a meningeal melanocytoma.
• Immunohistochemical analysis confirmed the diagnosis with strong HMB-45 positivity.
• Tumor cells were also positive for Vimentin and S-100, focally for neuron-specific enolase, and negative for epithelial membrane antigen.

Implications:

• This case contributes to the understanding of rare benign meningeal tumors.
• Accurate diagnosis through histopathology and immunohistochemistry is crucial for appropriate management.
• Successful surgical excision offers a favorable outcome for meningeal melanocytoma.