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Journal of Neurosurgical Sciences 2001 December;45(4):235-40

language: English

Primary lep­tom­e­nin­geal melan­o­mat­o­sis: ear­ly lep­tom­e­nin­geal enhance­ment on MRI

Celli P., Acqui M., Trillò G., Ramundo E. O., D'Andrea G., Roperto R., Ferrante L.

Department of Neurological Sciences, II Chair of Neurosurgery, University of Rome “La Sapienza”, Rome, Italy


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One unusu­al ­case of pri­mary lep­tom­e­nin­geal melan­o­mat­o­sis is pre­sent­ed. The ­patient, 53-­year-old ­male, was admit­ted to our obser­va­tion for 1 ­month his­to­ry of psy­chas­the­nia and amne­sia. Despite sev­er­al poly­spe­cia­lis­tic clin­i­cal, neu­ro­ra­dio­log­i­cal and cyto­log­i­cal exam­ina­tions, con­clu­sive diag­no­sis was ­made ­only ­with a biop­sy of lep­tom­e­nin­geal nod­ule. The ­present ­case ­allows as to iden­ti­fy 2 stag­es in the evo­lu­tion of pri­mary dif­fuse lep­tom­e­nin­geal melan­o­mat­o­sis. The ­initial ­phase is char­ac­ter­ized by ­slight men­tal impair­ment with­out hydro­ceph­a­lus; dur­ing the lat­er ­phase ­there is ­severe, dif­fuse neu­ro­log­i­cal impair­ment and ­both CT and MRI ­show hyper­cap­ta­tion of the intra­cra­ni­al lep­to­me­ning­es and mul­ti­ple, lep­tom­e­nin­geal tumo­ral nod­ules.

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