AUTHOR=Ferreira de Araújo Mayle Gomes , Almondes Santana Lemos Luiz Euripedes , Negromonte Guerra Pedro Lucas , Marcia dos Santos Lima Didjurgeit Fernanda , Batista Cezar Auricelio , Faquini Igor Vilela , Cirne de Azevedo Filho Hildo Rocha 

TITLE=Supratentorial meningeal melanocytoma mimicking meningioma: case report and literature review

JOURNAL=Pathology and Oncology Research

VOLUME=Volume 29 - 2023

YEAR=2024

URL=https://www.por-journal.com/journals/pathology-and-oncology-research/articles/10.3389/pore.2023.1611482

DOI=10.3389/pore.2023.1611482

ISSN=1532-2807

ABSTRACT=Primary melanocytic tumors of the central nervous system (CNS) are lesions derived from melanocytes and were first described in 1859 by Rudolf Virchow (1). In the already-formed CNS, these cells are found in the leptomeninges (arachnoid and pia mater), with their highest concentration in the upper portion of the spinal cord (2).Unlike secondary melanomas that affect the CNS, which have a high incidence, primary melanocytic tumors of the CNS are rare, with an incidence of 0.7 cases per 10 million inhabitants per year (3,4,6).In the latest classification of CNS neoplasms by the World Health Organization (WHO) in 2021, primary CNS melanocytic tumors were categorized into four types (Table 01): primary leptomeningeal melanoma, primary leptomeningeal melanocytoma, primary leptomeningeal melanomatosis, and primary leptomeningeal melanocytosis (5).Among these, primary leptomeningeal melanocytomas (the focus of this study) are benign neoplasms with a low incidence in the population, affecting less than one patient in every 10 million per year. Unlike other primary melanocytic tumors of the leptomeninges, they are more common in women, ranging in age from 20 to 80 years, with a peak incidence in the population aged between 40 and 50 years (6).It is a benign tumor that can be found anywhere in the CNS, most commonly affecting the spinal cord, especially the cervical spine, and the posterior fossa, with a supratentorial location being less common . The intracranial areas most commonly involved are the skull base, the cerebellopontine angle, the pineal region, and the Cavum of Meckel. Two cases of lesions in the convexity region that mimicked convexity meningiomas have been described, one in 2012 by Lin et al. ( 8) and the other in 2006 by Beseoglu et al. (9).These are solitary lesions, usually compressing and not invading adjacent brain tissue. Clinical manifestations are caused by increased intracranial pressure, leading the patient to suffer from seizures, migraines, subarachnoid hemorrhages, and focal neurological deficits.The prognosis for these patients is generally favorable, but local recurrence is not uncommon. Complete surgical resection of the lesion is the recommended treatment. Some authors suggest adjuvant radiotherapy in cases of both complete and partial resection of the lesion.