MR Imaging Findings of the Intraspinal Meningeal Melanocytoma: Correlation with Histopathologic Findings

G.Q. Hou; J.C. Sun; X.J. Zhang; B.X. Shen; X.J. Zhu; L. Liang; X.L. Zhang

doi:10.3174/ajnr.A2987

Abstract

SUMMARY: Our aim was to better understand and improve the accuracy of the preoperative diagnosis of intraspinal MM by a combined analysis of MR imaging and pathologic findings. All 5 patients had undergone unenhanced and contrast-enhanced MR imaging examinations. All tumor samples had immunohistochemical reactions to HMB-45, vimentin, S-100, EMA, and Leu-7 antibodies. All 5 cases were located in the intradural extramedullary compartment. Two cases had multifocal lesions, and 3 cases were solitary. Two cases showed homogeneously strong enhancement, and 3 cases showed moderate enhancement on contrast-enhanced T1WI. The tumor cells had positive reactions to HMB-45, vimentin, and S-100 antibodies. MR imaging plays an important role in the detection and diagnosis of intraspinal MM. Final diagnosis should be based on histopathology and IHC examinations.

ABBREVIATIONS:

EMA: epithelial membrane antigen
HMB-45: human melanoma black-45
IHC: immunohistochemistry
MM: meningeal melanocytoma

Primary melanocytic neoplasms of the CNS are lesions arising from melanocytes of the leptomeninges. Melanocytes are melanin-producing cells that derive from the neural crest during embryogenesis and then migrate to the skin, mucous membranes, and CNS.¹ Melanocytes are often concentrated at the base of the brain and on the ventral surface of the cervical spinal cord. Melanocytic neoplasms of the CNS are rare and most frequently are metastatic in origin. Primary melanocytic lesions of the CNS include neurocutaneous melanosis, MM, primary leptomeningeal melanomatosis, and melanoma.

MM is a rare primary benign melanotic tumor of the leptomeninges, which occurs anywhere in the cranial or spinal region but most commonly in the supratentorial and thoracic spine regions.² It was first described by Limas and Tio³ in 1972 with a prolonged clinical course and benign histologic features.⁴ From 1972 to 2009, <60 cases of intraspinal MM were reported.⁵ Here, we report 5 cases of intraspinal MM. To our knowledge, this study is the largest collection of intraspinal MM cases with MR imaging to date.

Materials and Methods

We searched the data base of our hospital for all intraspinal tumors from 2003 to 2010. The clinicopathologic data and MR imaging findings of 5 cases of MM were analyzed retrospectively. The patients included 1 woman and 4 men with the average age of 49 years. The main clinical symptoms were gradually worsening debilitation of the lower limb (n = 5), leg numbness (n = 3), lumbodynia (n = 1), dorsodynia (n = 1), and dizziness (n = 1). The On-line Table shows the clinical data and MR imaging findings of all patients.

The patients were examined with MR imaging at 1.5T (n = 3) or 3T (n = 2). Spin-echo or fast spin-echo T1WI and T2WI in the axial, coronal, or sagittal planes were acquired. The corresponding contrast-enhanced T1WI was obtained after intravenous injection of 0.1 mmol/kg of gadopentetate dimeglumine (Magnevist; Schering, Berlin, Germany).

Two neuroradiologists reviewed the MR images separately. All lesions were removed by open surgery. HMB-45, vimentin, S-100, EMA, and Leu-7 antibodies were purchased from Dako North America (Carpinteria, California). The final diagnoses were established by 2 pathologists after reviewing the clinical process, the macroscopic protocols, and the histologic slides.

Results

All 5 cases were located in the intradural extramedullary compartment, with the results revealing that the spine was obviously compressed (Figs 1 and 2). All lesions were tightly attached to the dura mater. Two cases were multifocal and others had solitary lesions. The single lateral intervertebral foramen was widened (n = 1). T1WI showed homogeneous hyperintensity (n = 2), moderate hyperintensity (n = 2), and isointensity (n = 1); T2WI showed homogeneous hypointensity (n = 3), moderate hyperintensity (n = 1), and isointensity (n = 1). Two cases showed homogeneously strong enhancement, and others showed moderate enhancement on contrast-enhanced T1WI (Fig 1 and On-line Table).

Fig 1.

In case 1 (A and B), 3 lesions are shown on sagittal nonenhanced MR images of the cervical vertebrae at the C4-T2 level. In case 2 (C and D), the lesion is shown on sagittal nonenhanced MR images of the thoracic vertebrae at the T7-T8 level. In case 3, the lesion is shown on sagittal (E) and coronal (F) nonenhanced MR images of the thoracic vertebrae at the T11-T12 level.

All the tumors showed well-defined, round, or ovoid masses. Three cases were solitary, and others were multifocal. The cut surfaces and peripheral meninges of the tumors were all in black. Tumor cells were spindle, epithelioid, or polygonal with round vesicular nuclei, prominent nucleoli, and plenty of melanin granules in the cytoplasm. They had a uniform cytologic appearance and lacked evidence of atypia or significant mitotic activity. Tumor cells demonstrated storiform vasocentric arrangements. In case 2, the amount of melanin-containing cells was <10%, while in the other 4 cases, >10% of tumor cells had melanin granules in the cytoplasm, even masking the morphology of the nucleus (Fig 2). Tumor cells had a positive reaction to anti-HMB-45, vimentin, and S-100 antibodies but a negative reaction to anti-EMA and Leu-7 (Fig 3). All 5 cases were finally diagnosed as intraspinal MM. All patients underwent surgical resection and radiation therapy. To date, 4 patients are alive (22–37 months after surgery; mean, 28 months), and follow-up MR imaging showed no signs of tumor recurrence. One patient with multifocal lesions developed malignant melanoma and died of metastasis 13 months after surgery.

Fig 2.

In case 1, the sagittal (A) and axial (D) contrast-enhanced T1WI and morphologic changes (G, HE original magnification ×400) of the lesion are seen. In case 2, the sagittal (B) and axial (E) contrast-enhanced T1WI sequences and morphologic changes (H, HE original magnification ×200) of the lesion are seen. In case 3, the sagittal (C) and axial (F) contrast-enhanced T1WI sequence and morphologic changes (I, HE original magnification ×400) of the lesion are shown.

Fig 3.

IHC detection of MM (DAB stain). The tumor cells have a negative reaction to the EMA antibody (A, original magnification ×200) but positive reactions to vimentin (B, ×200), HMB-45 (C, original magnification ×400), and S-100 (D, original magnification ×200).

Discussion

Melanocytes originate from the neural crest and are normally found in the leptomeninges.^2,4 These cells are present in the leptomeninges of healthy adults and may result in primary leptomeningeal pigmented tumors, including pigmented meningioma, malignant melanoma, MM, melanotic schwannoma, and melanoblastosis.^6,7 Malignant melanoma and MM are of the same origin and represent the malignant and benign ends of the tumor spectrum, respectively.⁵

MM was first coined by Limas and Tio³ in 1972. It is a very rare, pigmented, and slow-growing benign neoplasm.⁸ However, malignant transformation of melanocytoma to malignant melanoma has been reported.^5,9 To date, approximately 112 cases of MM have been reported,⁵ and most were found in the cerebrum. The tumor occurs almost exclusively in the posterior fossa and spinal cord.^6,7,10,11 The annual incidence of MM is estimated to be 1 case per 10 million people, and women are vulnerable.¹⁰ Our hospital has an extremely large collection area for patients from Guangdong province and 4 neighboring provinces. The orthopedics center in our hospital is very famous and is also a referral center for spinal tumors. Therefore, we have collected 5 cases of patients with MM in the past 7 years. The incidence is not affected by race or genetic risk factor, and there are no literature reports about MM, to our knowledge. MM may occur at any age but is most commonly seen in the fifth decade. The average age in our series is 49.2 years, which is consistent with that in other reports.^10,11

Approximate 59 cases of intraspinal MM have been reported.⁵ Nineteen cases were founded in the intramedullary location, while others were located in the extramedullary area.^5,9 The clinical signs and symptoms depend on its location and may present as myelopathy and seizures.^10,12 The symptoms of our patients were nonspecific, mainly caused by mass compression.

Most MMs are commonly found as a solitary lesion, but they can also present as multifocal or disseminating along the arachnoid and dura mater.^13,14 To date, approximately 4 cases with multifocal lesions have been reported.^15,16 Ali et al⁶ considered multifocal MM as a distinct pathologic entity that seems to portend an aggressive clinical course and a poor prognosis, even when malignant pathologic features are absent.

In our study, 2 patients with multifocal lesions did not show malignant pathologic features compared with those with solitary lesions, but 1 patient with multifocal lesions developed malignant melanoma and died of metastasis 13 months after surgery. It has been reported that MM might transform into malignant melanoma^9,17 and then cause distant metastasis.²⁸ Our study also supports multifocal MM possibly predicting a poor outcome.

MR imaging is the first choice for spinal tumors. On MR imaging, MM is generally an attenuated extra-axial lesion attached to the dura, which may not have a distinct margin.⁵ It is typically hyperintense on T1WI and hypointense on T2WI and enhances homogeneously with gadolinium.^{10,16⇓⇓–19} The characteristic signal intensity of MM is thought to be caused by the paramagnetic susceptibility effect of the melanin pigment or hemorrhagic foci; hence, its radiologic signal intensity is variable and inconstant.^16,19,20 However, differences in duration, different amounts of melanin, and hemorrhage in malignant melanoma may influence the signal intensity of tumor cells on MR imaging.^9,14,19,20

Amelanotic melanoma and melanoma without hemorrhage are iso- or hypointense on T1WI and moderately hyperintense on T2WI.^21⇓–23 Isiklar et al²⁴ reviewed the MR images of 30 patients with intracerebral melanoma and sorted these into 4 groups: melanotic pattern (hyperintense on T1WI, hypointense on T2WI), amelanotic pattern (hypointense or isointense on T1WI and hyperintense or isontense on T2WI), indeterminate or mixed pattern (MR imaging characteristics not conforming to the first 2 categories), and hematoma pattern (MR imaging exhibiting only hematoma characteristics).²⁷ In our study, cases with >10% of melanin-containing cells showed a melanotic pattern, while case 2 did not have typical MR imaging and was then proved to have <10% melanin-containing cells by histopathology.

Wadasadawala et al²² considered the following aspects useful for the differential diagnosis of MM: 1) Location: Pigmented meningioma is located in the extra-axial area; melanotic schwannoma is located in the cerebellopontine angle; MM and primary melanoma are often located in the high cervical cord or perimedullary area, whereas metastatic melanoma is located in the supratentorial or gray-white matter junction. 2) Number: The lesion of pigmented meningioma, MM, or primary melanoma is often single, while metastatic melanoma is multiple. 3) Hemorrhage: The pigmented meningioma and melanotic schwannoma do not have a hemorrhagic focus, while MM and primary and metastatic melanoma often have it.²² 4) Dural involvement: Dural involvement and the “dural tail” sign are often observed in meningioma, MM, or meningeal melanocytosis, but metastatic melanoma seldom presents dural involvement.

Because the differential diagnosis of MM from other pigmented malignancies is difficult on the basis of only the imaging information, a final diagnosis is dependent on the results of pathologic examination. Grossly, MM usually presents as a solitary well-circumscribed black mass, while lesions in red, white, tan, brown, or blue have been reported.^10,23,24 MMs may be mistaken for meningioma at gross inspection because they are attached to the meninges. MM cells tend to compress adjacent tissues instead of infiltrating them. However, local invasion of neural structures has been reported in some cases.^6,25,26 The cytologic feature of MM is uniform, lacking in atypia and mitotic activity and showing different degrees of melanization.^{12,27⇓⇓–30}

IHC staining is always indispensable for differentiating MM from other pigmented tumors. MM is characterized by a positive reaction to HMB-45, vimentin, and S-100 proteins¹² and a negative reaction to EMA and Leu-7.^7,20 Meningioma cells lack the expressions of HMB-45 and S-100, and a positive reaction to EMA differentiates pigmented meningioma from MM.^7,12 The absence of a reaction to Leu-7 excludes the diagnosis of melanocytic schwannoma.^7,28 Vimentin usually appears in MM but is only rarely present in malignant melanoma. Ultrastructurally, desmosomes are characteristic of meningioma but are generally absent in MM.^3,5,19 However, a differential diagnosis between MM and malignant leptomeningeal melanoma may present some difficulties.²⁰ Because the histologic characteristics of MM and melanoma are overlapping, thorough physical and radiologic examinations of the patient are required to exclude a primary cutaneous, ocular, or mucosal melanoma.^5,10

Conclusions

We report 5 rare cases of intraspinal MM. To date, to our knowledge, this is the largest collection of intraspinal MM cases with MR imaging. MR imaging plays an important role in the detection and diagnosis of intraspinal MM. The different amounts of melanin-containing cells or hemorrhage may influence the MR imaging signal intensity of tumor cells. Final diagnosis should be based on histopathology and IHC examinations.

Acknowledgments

The authors thank Mou Ren-Qi for his assistance with the study.

Footnotes

The first 2 authors contributed equally to this work.

References

1.↵
1. Kwon SC,
2. Rhim SC,
3. Lee DH,
4. et al
. Primary malignant melanoma of the cervical spinal nerve root. Yonsei Med J 2004; 45: 345– 48
PubMed
2.↵
1. El-Khashab M,
2. Koral K,
3. Bowers DC,
4. et al
. Intermediate grade meningeal melanocytoma of cervical spine. Childs Nerv Syst 2009; 25: 407– 10
CrossRef PubMed
3.↵
1. Limas C,
2. Tio FO
. Meningeal melanocytoma (“melanotic meningioma”): its melanocytic origin as revealed by electron microscopy. Cancer 1972; 30: 1286– 94
CrossRef PubMed
4.↵
1. Czarnecki EJ,
2. Silbergleit R,
3. Gutierrez JA
. MR of spinal meningeal melanocytoma. AJNR Am J Neuroradiol 1997; 18: 180– 82
Abstract
5.↵
1. Liubinas SV,
2. Maartens N,
3. Drummond KJ
. Primary melanocytic neoplasms of the central nervous system. J Clin Neurosci 2010; 17: 1227– 32
CrossRef PubMed
6.↵
1. Ali Y,
2. Rahme R,
3. Moussa R,
4. et al
. Multifocal meningeal melanocytoma: a new pathological entity or the result of leptomeningeal seeding? J Neurosurg 2009; 111: 488– 91
CrossRef PubMed
7.↵
1. Painter TJ,
2. Chaljub G,
3. Sethi R,
4. et al
. Intracranial and intraspinal meningeal melanocytosis. AJNR Am J Neuroradiol 2000; 21: 1349– 53
Abstract/FREE Full Text
8.↵
1. Karikari IO,
2. Powers CJ,
3. Bagley CA,
4. et al
. Primary intramedullary melanocytoma of the spinal cord: case report. Neurosurgery 2009; 64: E777– 78
CrossRef
9.↵
1. Rades D,
2. Schild SE,
3. Tatagiba M,
4. et al
. Therapy of meningeal melanocytomas. Cancer 2004; 100: 2442– 47
CrossRef PubMed
10.↵
1. Smith AB,
2. Rushing EJ,
3. Smirniotopoulos JG
. Pigmented lesions of the central nervous system: radiologic-pathologic correlation. Radiographics 2009; 29: 1503– 24
CrossRef PubMed
11.↵
1. Chen CJ,
2. Hsu YI,
3. Ho YS,
4. et al
. Intracranial meningeal melanocytoma: CT and MRI. Neuroradiology 1997; 39: 811– 14
CrossRef PubMed
12.↵
1. Bydon A,
2. Gutierrez JA,
3. Mahmood A
. Meningeal melanocytoma: an aggressive course for a benign tumor. J Neurooncol 2003; 64: 259– 63
CrossRef PubMed
13.↵
1. Horn EM,
2. Nakaji P,
3. Coons SW,
4. et al
. Surgical treatment for intramedullary spinal cord melanocytomas. J Neurosurg Spine 2008; 9: 48– 54
CrossRef PubMed
14.↵
1. Shownkeen HN,
2. Harmath C,
3. Thomas C
. Multiform cervical melanocytoma: a case report. Neuroradiology 2002; 44: 1008– 10
CrossRef PubMed
15.↵
1. Iida M,
2. Llena JF,
3. Suarez MA,
4. et al
. Two cases of spinal meningeal melanocytoma. Brain Tumor Pathol 2002; 19: 41– 45
CrossRef PubMed
16.↵
1. O'Brien DF,
2. Crooks D,
3. Mallucci C,
4. et al
. Meningeal melanocytoma. Childs Nerv Syst 2006; 22: 556– 61
CrossRef PubMed
17.↵
1. Roser F,
2. Nakamura M,
3. Brandis A,
4. et al
. Transition from meningeal melanocytoma to primary cerebral melanoma. J Neurosurg 2004; 101: 528– 31
CrossRef PubMed
18.↵
1. Wang F,
2. Li X,
3. Chen L,
4. et al
. Malignant transformation of spinal meningeal melanocytoma: case report and review of the literature. J Neurosurg Spine 2007; 6: 451– 54
CrossRef PubMed
19.↵
1. Uematsu Y,
2. Yukawa S,
3. Yokote H,
4. et al
. Meningeal melanocytoma: magnetic resonance imaging characteristics and pathological features-case report. J Neurosurg 1992; 76: 705– 09
CrossRef PubMed
20.↵
1. Ruelle A,
2. Tunesi G,
3. Andrioli G
. Spinal meningeal melanocytoma: case report and analysis of diagnostic criteria. Neurosurg Rev 1996; 19: 39– 42
CrossRef PubMed
21.↵
1. Farrokh D,
2. Fransen P,
3. Faverly D
. MR findings of a primary intramedullary malignant melanoma: case report and literature review. AJNR Am J Neuroradiol 2001; 22: 1864– 66
Abstract/FREE Full Text
22.↵
1. Wadasadawala T,
2. Trivedi S,
3. Gupta T,
4. et al
. The diagnostic dilemma of primary central nervous system melanoma. J Clin Neurosci 2010; 17: 1014– 17
CrossRef PubMed
23.↵
1. Vanzieleghem BD,
2. Lemmerling MM,
3. Van Coster RN
. Neurocutaneous melanosis presenting with intracranial amelanotic melanoma. AJNR Am J Neuroradiol 1999; 20: 457– 60
Abstract/FREE Full Text
24.↵
1. Isiklar I,
2. Leeds NE,
3. Fuller GN,
4. et al
. Intracranial metastatic melanoma: correlation between MR imaging characteristics and melanin content. AJR Am J Roentgenol 1995; 165: 1503– 12
PubMed
25.↵
1. Ahluwalia S,
2. Ashkan K,
3. Casey AT
. Meningeal melanocytoma: clinical features and review of the literature. Br J Neurosurg 2003; 17: 347– 51
CrossRef PubMed
26.↵
1. Chow M,
2. Clarke DB,
3. Maloney WJ,
4. et al
. Meningeal melanocytoma of the planum sphenoidale: case report and review of the literature. J Neurosurg 2001; 94: 841– 45
CrossRef PubMed
27.↵
1. Czirjak S,
2. Vitanovic D,
3. Slowik F,
4. et al
. Primary meningeal melanocytoma of the pineal region. J Neurosurg 2000; 92: 461– 65
CrossRef PubMed
28.↵
1. Offiah CJ,
2. Laitt RD
. Intracranial meningeal melanocytoma: a cause of high signal on T1- and low signal on T2-weighted MRI. Clin Radiol 2006; 61: 294– 98
CrossRef PubMed
29.↵
1. Kleihues P,
2. Cavenee WK
1. Jellinger K,
2. Chou P,
3. Paulus W
. Melanocytic lesions. In: Kleihues P, Cavenee WK eds. World Health Organization Classification of Tumours: Pathology and Genetics of Tumours of the Nervous System. Lyon, France: IARC Press: 2000: 193– 95
30.↵
1. Prayson RA,
2. Cohen ML
1. Prayson RA,
2. Cohen ML
. Melanocytic lesions. In: Prayson RA, Cohen ML . Practical Differential Diagnosis in Surgical Neuropathology. Totowa, New Jersey: Humana Press; 2000: 137– 40

Received September 16, 2011.
Accepted after revision November 18, 2011.

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[1] 1.↵
Kwon SC,
Rhim SC,
Lee DH,
et al
. Primary malignant melanoma of the cervical spinal nerve root. Yonsei Med J 2004; 45: 345– 48
PubMed

[2] Kwon SC,

[3] Rhim SC,

[4] Lee DH,

[5] et al

[6] 2.↵
El-Khashab M,
Koral K,
Bowers DC,
et al
. Intermediate grade meningeal melanocytoma of cervical spine. Childs Nerv Syst 2009; 25: 407– 10
CrossRef PubMed

[7] El-Khashab M,

[8] Koral K,

[9] Bowers DC,

[10] et al

[11] 3.↵
Limas C,
Tio FO
. Meningeal melanocytoma (“melanotic meningioma”): its melanocytic origin as revealed by electron microscopy. Cancer 1972; 30: 1286– 94
CrossRef PubMed

[12] Limas C,

[13] Tio FO

[14] 4.↵
Czarnecki EJ,
Silbergleit R,
Gutierrez JA
. MR of spinal meningeal melanocytoma. AJNR Am J Neuroradiol 1997; 18: 180– 82
Abstract

[15] Czarnecki EJ,

[16] Silbergleit R,

[17] Gutierrez JA

[18] 5.↵
Liubinas SV,
Maartens N,
Drummond KJ
. Primary melanocytic neoplasms of the central nervous system. J Clin Neurosci 2010; 17: 1227– 32
CrossRef PubMed

[19] Liubinas SV,

[20] Maartens N,

[21] Drummond KJ

[22] 6.↵
Ali Y,
Rahme R,
Moussa R,
et al
. Multifocal meningeal melanocytoma: a new pathological entity or the result of leptomeningeal seeding? J Neurosurg 2009; 111: 488– 91
CrossRef PubMed

[23] Ali Y,

[24] Rahme R,

[25] Moussa R,

[26] et al

[27] 7.↵
Painter TJ,
Chaljub G,
Sethi R,
et al
. Intracranial and intraspinal meningeal melanocytosis. AJNR Am J Neuroradiol 2000; 21: 1349– 53
Abstract/FREE Full Text

[28] Painter TJ,

[29] Chaljub G,

[30] Sethi R,

[31] et al

[32] 8.↵
Karikari IO,
Powers CJ,
Bagley CA,
et al
. Primary intramedullary melanocytoma of the spinal cord: case report. Neurosurgery 2009; 64: E777– 78
CrossRef

[33] Karikari IO,

[34] Powers CJ,

[35] Bagley CA,

[36] et al

[37] 9.↵
Rades D,
Schild SE,
Tatagiba M,
et al
. Therapy of meningeal melanocytomas. Cancer 2004; 100: 2442– 47
CrossRef PubMed

[38] Rades D,

[39] Schild SE,

[40] Tatagiba M,

[41] et al

[42] 10.↵
Smith AB,
Rushing EJ,
Smirniotopoulos JG
. Pigmented lesions of the central nervous system: radiologic-pathologic correlation. Radiographics 2009; 29: 1503– 24
CrossRef PubMed

[43] Smith AB,

[44] Rushing EJ,

[45] Smirniotopoulos JG

[46] 11.↵
Chen CJ,
Hsu YI,
Ho YS,
et al
. Intracranial meningeal melanocytoma: CT and MRI. Neuroradiology 1997; 39: 811– 14
CrossRef PubMed

[47] Chen CJ,

[48] Hsu YI,

[49] Ho YS,

[50] et al

[51] 12.↵
Bydon A,
Gutierrez JA,
Mahmood A
. Meningeal melanocytoma: an aggressive course for a benign tumor. J Neurooncol 2003; 64: 259– 63
CrossRef PubMed

[52] Bydon A,

[53] Gutierrez JA,

[54] Mahmood A

[55] 13.↵
Horn EM,
Nakaji P,
Coons SW,
et al
. Surgical treatment for intramedullary spinal cord melanocytomas. J Neurosurg Spine 2008; 9: 48– 54
CrossRef PubMed

[56] Horn EM,

[57] Nakaji P,

[58] Coons SW,

[59] et al

[60] 14.↵
Shownkeen HN,
Harmath C,
Thomas C
. Multiform cervical melanocytoma: a case report. Neuroradiology 2002; 44: 1008– 10
CrossRef PubMed

[61] Shownkeen HN,

[62] Harmath C,

[63] Thomas C

[64] 15.↵
Iida M,
Llena JF,
Suarez MA,
et al
. Two cases of spinal meningeal melanocytoma. Brain Tumor Pathol 2002; 19: 41– 45
CrossRef PubMed

[65] Iida M,

[66] Llena JF,

[67] Suarez MA,

[68] et al

[69] 16.↵
O'Brien DF,
Crooks D,
Mallucci C,
et al
. Meningeal melanocytoma. Childs Nerv Syst 2006; 22: 556– 61
CrossRef PubMed

[70] O'Brien DF,

[71] Crooks D,

[72] Mallucci C,

[73] et al

[74] 17.↵
Roser F,
Nakamura M,
Brandis A,
et al
. Transition from meningeal melanocytoma to primary cerebral melanoma. J Neurosurg 2004; 101: 528– 31
CrossRef PubMed

[75] Roser F,

[76] Nakamura M,

[77] Brandis A,

[78] et al

[79] 18.↵
Wang F,
Li X,
Chen L,
et al
. Malignant transformation of spinal meningeal melanocytoma: case report and review of the literature. J Neurosurg Spine 2007; 6: 451– 54
CrossRef PubMed

[80] Wang F,

[81] Li X,

[82] Chen L,

[83] et al

[84] 19.↵
Uematsu Y,
Yukawa S,
Yokote H,
et al
. Meningeal melanocytoma: magnetic resonance imaging characteristics and pathological features-case report. J Neurosurg 1992; 76: 705– 09
CrossRef PubMed

[85] Uematsu Y,

[86] Yukawa S,

[87] Yokote H,

[88] et al

[89] 20.↵
Ruelle A,
Tunesi G,
Andrioli G
. Spinal meningeal melanocytoma: case report and analysis of diagnostic criteria. Neurosurg Rev 1996; 19: 39– 42
CrossRef PubMed

[90] Ruelle A,

[91] Tunesi G,

[92] Andrioli G

[93] 21.↵
Farrokh D,
Fransen P,
Faverly D
. MR findings of a primary intramedullary malignant melanoma: case report and literature review. AJNR Am J Neuroradiol 2001; 22: 1864– 66
Abstract/FREE Full Text

[94] Farrokh D,

[95] Fransen P,

[96] Faverly D

[97] 22.↵
Wadasadawala T,
Trivedi S,
Gupta T,
et al
. The diagnostic dilemma of primary central nervous system melanoma. J Clin Neurosci 2010; 17: 1014– 17
CrossRef PubMed

[98] Wadasadawala T,

[99] Trivedi S,

[100] Gupta T,

[101] et al

[102] 23.↵
Vanzieleghem BD,
Lemmerling MM,
Van Coster RN
. Neurocutaneous melanosis presenting with intracranial amelanotic melanoma. AJNR Am J Neuroradiol 1999; 20: 457– 60
Abstract/FREE Full Text

[103] Vanzieleghem BD,

[104] Lemmerling MM,

[105] Van Coster RN

[106] 24.↵
Isiklar I,
Leeds NE,
Fuller GN,
et al
. Intracranial metastatic melanoma: correlation between MR imaging characteristics and melanin content. AJR Am J Roentgenol 1995; 165: 1503– 12
PubMed

[107] Isiklar I,

[108] Leeds NE,

[109] Fuller GN,

[110] et al

[111] 25.↵
Ahluwalia S,
Ashkan K,
Casey AT
. Meningeal melanocytoma: clinical features and review of the literature. Br J Neurosurg 2003; 17: 347– 51
CrossRef PubMed

[112] Ahluwalia S,

[113] Ashkan K,

[114] Casey AT

[115] 26.↵
Chow M,
Clarke DB,
Maloney WJ,
et al
. Meningeal melanocytoma of the planum sphenoidale: case report and review of the literature. J Neurosurg 2001; 94: 841– 45
CrossRef PubMed

[116] Chow M,

[117] Clarke DB,

[118] Maloney WJ,

[119] et al

[120] 27.↵
Czirjak S,
Vitanovic D,
Slowik F,
et al
. Primary meningeal melanocytoma of the pineal region. J Neurosurg 2000; 92: 461– 65
CrossRef PubMed

[121] Czirjak S,

[122] Vitanovic D,

[123] Slowik F,

[124] et al

[125] 28.↵
Offiah CJ,
Laitt RD
. Intracranial meningeal melanocytoma: a cause of high signal on T1- and low signal on T2-weighted MRI. Clin Radiol 2006; 61: 294– 98
CrossRef PubMed

[126] Offiah CJ,

[127] Laitt RD

[128] 29.↵
Kleihues P,
Cavenee WK
Jellinger K,
Chou P,
Paulus W
. Melanocytic lesions. In: Kleihues P, Cavenee WK eds. World Health Organization Classification of Tumours: Pathology and Genetics of Tumours of the Nervous System. Lyon, France: IARC Press: 2000: 193– 95

[129] Kleihues P,

[130] Cavenee WK

[131] Jellinger K,

[132] Chou P,

[133] Paulus W

[134] 30.↵
Prayson RA,
Cohen ML
Prayson RA,
Cohen ML
. Melanocytic lesions. In: Prayson RA, Cohen ML . Practical Differential Diagnosis in Surgical Neuropathology. Totowa, New Jersey: Humana Press; 2000: 137– 40

[135] Prayson RA,

[136] Cohen ML

[137] Prayson RA,

[138] Cohen ML

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American Journal of Neuroradiology

MR Imaging Findings of the Intraspinal Meningeal Melanocytoma: Correlation with Histopathologic Findings

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MR Imaging Findings of the Intraspinal Meningeal Melanocytoma: Correlation with Histopathologic Findings

Abstract

ABBREVIATIONS:

Materials and Methods

Results

Discussion

Conclusions

Acknowledgments

Footnotes

References

In this issue

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Related Articles

Cited By...

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