CASE REPORTS   

Journal of Neurosurgical Sciences 2003 December;47(4):211-4

Copyright © 2004 EDIZIONI MINERVA MEDICA

lingua: Inglese

Meningeal melanocytoma of the temporal lobe. An uncommon tumor in an unusual location. Case report

Aimar E. ¹, Debernardi A. ¹, Tancioni F. ¹, Di Ieva A. ¹, Bossi P. ², Gaetani P ¹., Rodriguez Y Baena R. ¹

¹ Department of Neurosurgery Humanitas Clinical Institute, Rozzano (MI), Italy 2 Pathology Section, Humanitas Clinical Institute, Rozzano (MI), Italy

Meningeal melan­o­cy­to­mas are ­rare pig­ment­ed ­tumors of the cen­tral ner­vous ­system. These ­tumors are ­benign mel­a­not­ic ­lesions ­that ­derive ­from the mel­a­noc­y­tes of the lep­to­me­ning­es. They may ­occur any­where in the cra­ni­al and spi­nal menin­ges; how­ev­er, ­they are ­found prev­al­ent­ly in the pos­te­ri­or fos­sa and in the spi­nal ­cord. Their epi­dem­i­olog­i­cal fea­tures, nat­u­ral his­to­ry and ­response to treat­ment ­remain poor­ly under­stood, ­even if, in the ­last 2 ­years, ­some ­reviews ­have ­been pub­lished ­about it. We ­report a new ­case of intra­cra­ni­al supra­ten­to­ri­al menin­geal melan­o­cy­to­ma, in the tem­po­ral ­lobe, occur­ring in a 27-­year-old man, admit­ted to our Institute ­with a ­long-­time his­to­ry of sei­zures. We ­report his­to­log­i­cal and radio­log­i­cal char­ac­ter­is­tics of our ­case, and brief­ly ­review the ther­a­peu­ti­cal ­options report­ed in lit­er­a­ture. Preoperative neu­ro­ra­dio­log­i­cal find­ing is ­unclear; the pre­op­er­a­tive diag­no­sis is usu­al­ly menin­gio­ma, ­because of the ­long dura­tion of symp­tom­a­tol­o­gy and the radio­log­i­cal appear­ance of the ­lesion as an ­extra-­axial ­mass. Diagnosis of ­these ­lesions, as in our ­case, is ­made intra­op­er­a­tive­ly by the ­gross, jet-­black appear­ance of the ­tumor and by his­to­log­i­cal exam­ina­tion. In ­spite of the ­benign bio­log­ic beha­vi­our, the prog­no­sis ­remains uncer­tain, ­because of the pos­sible ­local recur­renc­es. According to the ­results of ­some ­works of the ­last ­years, it ­seems appro­pri­ate to use post­op­er­a­tive radio­ther­a­py for ­those ­patients ­with symp­to­mat­ic resid­u­al, pro­gres­sive or recur­rent ­tumors not amen­able to fur­ther resec­tion.