Primary Melanocytic Meningioma in the Left Temporal Lobe: A Case Report

Abstract

Background: Primary melanocytic neoplasms of the central nervous system (CNS) are rare lesions arising from melanocytes of the leptomeninges. These leptomeningeal melanocytes are found at highest density underneath the brain stem and along the upper cervical spinal cord. Thus, most reported cases of meningeal melanocytomas are located in the posterior fossa and the spinal cord, and presentation of the tumor in supratentorial is very rare.

Case presentation: A 19-year-old man presented with headache and seizure at our department. Neurological exams were otherwise normal. A left temporal space-occupying lesion was seen on magnetic resonance imaging. The mass was hyperintense on T1-weighted images and hypointense on T2-weighted images. On contrast-enhanced MR enhancement was shown. Prior to surgery, meningioma was diagnosed and gross tumor removal was performed.  After surgery pathological diagnosis was made as meningeal melanocytoma WHO grade 1, the patient received radiation therapy. No tumor was seen on follow-up MR images one year after surgery.

Conclusion: presentation of melanocytic meningioma in supratentorial is very rare. Although this lesion is benign, but may behave aggressively. For most cases complete surgical resection of the lesion is curative. To prevent relapse of the tumor radiation therapy is important, especially in cases of incomplete surgical resection.