Spinal meningeal melanocytoma in a 5-year-old child: a case report and review of literature

Ahmed M Salah El-Din,Mohamed F Alsawy,Hashem M Aboul-Ela,Ahmed Koheil,Ahmed H Ashry

doi:10.1186/s41983-018-0017-z

Ahmed M Salah El-Din, Mohamed F Alsawy + Show 3 more

Open Access

https://doi.org/10.1186/s41983-018-0017-z

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Abstract

BackgroundMeningeal melanocytoma is considered a rare lesion arising from leptomeningeal melanocytes. Nearly two thirds of meningeal melanocytomas were reported in the intracranial compartment and the remaining one third in the spine. Spinal melanocytomas can be extradural or intradural, with extradural variant being more common, and the majority of cases have been single reports.MethodsA 5-year-old male presented with a 4-month history of non-radiating low back pain persistent at rest, with otherwise non-remarkable medical history. The patient was neurologically intact with no deficits. Preoperatively, routine laboratory investigations were non-remarkable. MRI imaging was done and showed a lesion at the level of T11 to L4, hyperintense on T1 and hypointense on T2 with homogenous contrast enhancement. Intraoperatively, the lesion was hemorrhagic, brownish, and rubbery in consistency attached to the ventral dura. Microscopic picture revealed dense cytoplasmic brown melanin pigments, with no significant mitoses or nuclear atypia. What is unique about our case is the age of the patient (5 years).ResultsTo the best of our knowledge, after reviewing the literature, this is the youngest case to be reported.ConclusionsSMM is an extremely rare tumor with a benign course. Complete surgical excision should be attempted. Age of presentation may be as young as in our case and the diagnosis of such a tumor should never be excluded in this early age group with persistent low back ache.

Highlights

Meningeal melanocytoma is considered a rare lesion arising from leptomeningeal melanocytes
It is the benign pole of the spectrum of neoplastic leptomeningeal melanocyte proliferations that involves primary malignant melanoma at the other pole, from which it differs in behavior and aggressiveness by owing a much better prognosis than its malignant variant (Painter et al 2000)
Two thirds of meningeal melanocytomas were reported in the intracranial compartment and the remaining one third in the spine (Wang et al 2013)

Summary

Introduction

Meningeal melanocytoma is considered a rare lesion arising from leptomeningeal melanocytes It is the benign pole of the spectrum of neoplastic leptomeningeal melanocyte proliferations that involves primary malignant melanoma at the other pole, from which it differs in behavior and aggressiveness by owing a much better prognosis than its malignant variant (Painter et al 2000). They may arise anywhere in the cranial and spinal meninges. With around 60 cases reported in the literature, the majority of cases have been single reports (Mangels et al 2006) We present this case being the youngest patient diagnosed with spinal meningeal melanocytoma. Written informed consent was obtained from the patient for publication of this case report and accompanying images

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