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Intracranial Meningeal Melanocytomas: Clinicoradiologic Characteristics and Outcomes
1Department of Neurosurgery, Kasturba Medical College, Manipal, India.
Objective:
Melanocytes are neural crest derivatives. Intracranial meningeal melanocytomas (MM) are rare tumors and the available literature is sparse for these neoplasms. This review aims to provide a detailed and comprehensive literature review of these tumors.
Methods:
By searching online databases, a literature review was performed to include and analyze all cases of cranial MM reported to date. PRISMA guidelines were followed for the review process.
Results:
A total of 109 cases were analyzed. The male/female ratio was 1.2:1. The mean age was 40.3 years. The mean duration of symptoms was 23.9 months (range, 2 days-15 years). Cerebellopontine (CP) angle, suprasellar, and Meckel cave were the most common locations. Sixty-four patients (58%) underwent gross total resection (GTR). Twenty-eight patients (26%) received some form of adjuvant radiation. There were 29 recurrences (26%) and mean time to recurrence was 50.2 months. The recurrence rates (RRs) for GTR and subtotal resection were 20% and 42%, respectively. The extent of resection (subtotal resection) and tumor locations (CP angle and Meckel cave) were significantly associated with higher RR. Six patients (6.5%) had higher-grade transformations.
Conclusions:
Complete surgical resection is the ideal treatment and adjuvant radiation is to be considered for residual/recurrent tumors. Adjuvant radiotherapy may also be prescribed despite GTR, in locations with higher RR such as CP angle and Meckel cave. Because of higher-grade transformations and delayed recurrences, long-term follow-up is required.
