Intracranial Meningeal Melanocytomas: Clinicoradiologic Characteristics and Outcomes

Abstract

Melanocytes are neural crest derivatives. Intracranial meningeal melanocytomas (MM) are rare tumors and the available literature is sparse for these neoplasms. This review aims to provide a detailed and comprehensive literature review of these tumors. By searching online databases, a literature review was performed to include and analyze all cases of cranial MM reported to date. PRISMA guidelines were followed for the review process. A total of 109 cases were analyzed. The male/female ratio was 1.2:1. The mean age was 40.3 years. The mean duration of symptoms was 23.9 months (range, 2 days-15 years). Cerebellopontine (CP) angle, suprasellar, and Meckel cave were the most common locations. Sixty-four patients (58%) underwent gross total resection (GTR). Twenty-eight patients (26%) received some form of adjuvant radiation. There were 29 recurrences (26%) and mean time to recurrence was 50.2 months. The recurrence rates (RRs) for GTR and subtotal resection were 20% and 42%, respectively. The extent of resection (subtotal resection) and tumor locations (CP angle and Meckel cave) were significantly associated with higher RR. Six patients (6.5%) had higher-grade transformations. Complete surgical resection is the ideal treatment and adjuvant radiation is to be considered for residual/recurrent tumors. Adjuvant radiotherapy may also be prescribed despite GTR, in locations with higher RR such as CP angle and Meckel cave. Because of higher-grade transformations and delayed recurrences, long-term follow-up is required.