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Aggressive Primary Pediatric Intracranial Malignant Melanoma: Sphinx of the Tissue Diagnosis

Laxminadh Sivaraju1, Nandita Ghosal2, Anita Mahadevan3

  • 1Department of Neurosurgery, Sri Sathya Sai Institute of Higher Medical Sciences, Bengaluru, Karnataka, India.

Asian Journal of Neurosurgery
|April 3, 2019
PubMed

Insights

Diagnosing primary malignant melanoma (PMM) in the brain is challenging, especially in pediatric cases. This case highlights diagnostic difficulties and the aggressive nature of intracranial PMM.

Area of Science:

  • Neuro-oncology
  • Pediatric Oncology
  • Dermatopathology

Background:

  • Primary malignant melanoma (PMM) of the brain is rare, particularly in children.
  • Diagnosis is complicated by the absence of neurocutaneous melanosis.
  • Intracranial PMM presents unique challenges in pediatric neurosurgery and oncology.

Observation:

  • A 16-year-old male presented with a brain lesion.
  • Intraoperative appearance was atypical, resembling a hematoma.
  • Histopathology revealed papillary architecture, mimicking meningioma or ependymoma.

Findings:

  • The lesion was confirmed as primary malignant melanoma.
  • Histological features were enigmatic, complicating initial diagnosis.
  • The tumor exhibited an aggressive nature with rapid progression.

Implications:

  • This case underscores the importance of considering PMM in pediatric brain tumors with unusual presentations.
  • Enigmatic histological features necessitate thorough diagnostic evaluation.
  • Aggressive behavior and rapid progression highlight the need for prompt and effective treatment strategies.
Keywords:
Immunohistochemistryintracranialpaediatricprimary malignant melanomaprognosis

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