Primary melanocytic melanoma of foramen magnum

Abstract

Meningeal melanocytomas are a group of benign tumors that arise from the leptomeningeal melanocytes. According to the World Health Organization, they belong to primary melanocytic lesions. These rare lesions pose a diagnostic challenge to a neurosurgeon, especially in the absence of cutaneous melanosis and often because it masquerades as other benign tumors on imaging. Complete microsurgical excision, proper histological diagnosis, and diligent search for primary are essential for the complete cure. One of the rare complications of high-grade melanoma is a thromboembolic event which can prove catastrophic despite a complete surgical excision. We report a case of a 39-year-old male who was diagnosed with foramen magnum melanoma and eventually succumbed to thromboembolic complication despite an uneventful total excision.