A rare case of multifocal craniospinal leptomeningeal melanocytoma: A case report and scoping review
Introduction: Leptomeningeal melanocytomas are rare tumours originating from neural crest derived melanocytes. They are usually solitary and presentation with multifocal meningeal melanocytoma is very rare and indicative of potentially more aggressive behaviour. This case report and scoping review s...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-01-01
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| Series: | Brain and Spine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772529424000535 |
| _version_ | 1797219316129595392 |
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| author | Daniel Lewis Timothy P. Dawson Rebecca Hyde George Adrian Rata Andrew F. Alalade Kaushik Ghosh Ahmed Elhabal |
| author_facet | Daniel Lewis Timothy P. Dawson Rebecca Hyde George Adrian Rata Andrew F. Alalade Kaushik Ghosh Ahmed Elhabal |
| author_sort | Daniel Lewis |
| collection | DOAJ |
| description | Introduction: Leptomeningeal melanocytomas are rare tumours originating from neural crest derived melanocytes. They are usually solitary and presentation with multifocal meningeal melanocytoma is very rare and indicative of potentially more aggressive behaviour. This case report and scoping review sought to evaluate the presentation, and key radiological features that can help differentiate multifocal meningeal melanocytoma from other differentials and provide a discussion of the key management and prognostic points once these tumours are diagnosed. Case presentation: A 26 year old male presented with neck pain radiating to both shoulders and subjective weakness in left shoulder movement. MRI demonstrated a large enhancing C2–C3 intradural-extramedullary lesion with further lesions at the T7/T8 level, left cerebellopontine angle and midline suprachiasmatic region. Whilst the imaging appearances were initially thought be indicative of a phacomatosis such as NF2-related schwannomatosis, surgical excision of the cervical tumour confirmed a melanocytic tumour of leptomeningeal origin, consistent with multifocal meningeal melanocytoma. Patient made a good post-operative recovery and remains under half yearly radiological surveillance, with repeat MRI 6 months after surgery demonstrating subtle growth of the untreated intracranial and spinal lesions. Literature review and conclusions: This is the first description, to our knowledge, of a multifocal meningeal melanocytoma associated with both cerebellopontine angle and suprasellar lesions. This case and included scoping review highlight the need to consider this rare diagnosis whenever multifocal craniospinal lesions are encountered, and the need to consider aggressive management through surgical resection and adjuvant craniospinal radiotherapy once these tumours are diagnosed. |
| first_indexed | 2024-04-24T12:31:42Z |
| format | Article |
| id | doaj.art-5d0007758bb2461287a66b51a5e4a6e5 |
| institution | Directory Open Access Journal |
| issn | 2772-5294 |
| language | English |
| last_indexed | 2024-04-24T12:31:42Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain and Spine |
| spelling | doaj.art-5d0007758bb2461287a66b51a5e4a6e52024-04-08T04:08:43ZengElsevierBrain and Spine2772-52942024-01-014102797A rare case of multifocal craniospinal leptomeningeal melanocytoma: A case report and scoping reviewDaniel Lewis0Timothy P. Dawson1Rebecca Hyde2George Adrian Rata3Andrew F. Alalade4Kaushik Ghosh5Ahmed Elhabal6Department of Neurosurgery, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK; Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Corresponding author. Department of Neurosurgery, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK.Department of Neuropathology, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, UKDepartment of Neuroradiology, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, UKDepartment of Neurosurgery, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UKDepartment of Neurosurgery, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UKDepartment of Neurosurgery, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UKDepartment of Neurosurgery, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UKIntroduction: Leptomeningeal melanocytomas are rare tumours originating from neural crest derived melanocytes. They are usually solitary and presentation with multifocal meningeal melanocytoma is very rare and indicative of potentially more aggressive behaviour. This case report and scoping review sought to evaluate the presentation, and key radiological features that can help differentiate multifocal meningeal melanocytoma from other differentials and provide a discussion of the key management and prognostic points once these tumours are diagnosed. Case presentation: A 26 year old male presented with neck pain radiating to both shoulders and subjective weakness in left shoulder movement. MRI demonstrated a large enhancing C2–C3 intradural-extramedullary lesion with further lesions at the T7/T8 level, left cerebellopontine angle and midline suprachiasmatic region. Whilst the imaging appearances were initially thought be indicative of a phacomatosis such as NF2-related schwannomatosis, surgical excision of the cervical tumour confirmed a melanocytic tumour of leptomeningeal origin, consistent with multifocal meningeal melanocytoma. Patient made a good post-operative recovery and remains under half yearly radiological surveillance, with repeat MRI 6 months after surgery demonstrating subtle growth of the untreated intracranial and spinal lesions. Literature review and conclusions: This is the first description, to our knowledge, of a multifocal meningeal melanocytoma associated with both cerebellopontine angle and suprasellar lesions. This case and included scoping review highlight the need to consider this rare diagnosis whenever multifocal craniospinal lesions are encountered, and the need to consider aggressive management through surgical resection and adjuvant craniospinal radiotherapy once these tumours are diagnosed.http://www.sciencedirect.com/science/article/pii/S2772529424000535Cervical spineIntradural-extramedullaryLeptomeningealMelanocytomaMelanocyteMultifocal |
| spellingShingle | Daniel Lewis Timothy P. Dawson Rebecca Hyde George Adrian Rata Andrew F. Alalade Kaushik Ghosh Ahmed Elhabal A rare case of multifocal craniospinal leptomeningeal melanocytoma: A case report and scoping review Brain and Spine Cervical spine Intradural-extramedullary Leptomeningeal Melanocytoma Melanocyte Multifocal |
| title | A rare case of multifocal craniospinal leptomeningeal melanocytoma: A case report and scoping review |
| title_full | A rare case of multifocal craniospinal leptomeningeal melanocytoma: A case report and scoping review |
| title_fullStr | A rare case of multifocal craniospinal leptomeningeal melanocytoma: A case report and scoping review |
| title_full_unstemmed | A rare case of multifocal craniospinal leptomeningeal melanocytoma: A case report and scoping review |
| title_short | A rare case of multifocal craniospinal leptomeningeal melanocytoma: A case report and scoping review |
| title_sort | rare case of multifocal craniospinal leptomeningeal melanocytoma a case report and scoping review |
| topic | Cervical spine Intradural-extramedullary Leptomeningeal Melanocytoma Melanocyte Multifocal |
| url | http://www.sciencedirect.com/science/article/pii/S2772529424000535 |
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