Pediatric primary diffuse leptomeningeal melanomatosis: Case report and review of the literature

Rationale: Primary melanocytic tumors of central nerve system (CNS) are rare, primary diffuse leptomeningeal melanomatosis (PDLM), a subtype of malignant melanomas of CNS, is extremely rare,especially in pediatrics. As the clinical manifestation of PDLM is not characteristic, It is often misdiagnosed as tubercular meningitis and hemorrhage. Patient concerns: A 13-year-old boy was admitted to our department with symptoms of recurrent headache and vomiting twice. As the brain imaging revealed a lesion located in the left temporal lobe mimicked hemorrhage, so there was a misdiagnosis of hemorrhage in first hospitalization. He was admitted again for the recurrence of the headache and vomiting. Detailed physical examination showed multiple melanin changes in the skin of the whole body which were ignored in last hospitalization. Brain imaging showed the significantly enlarged lesion in the left temporal lobe and several smaller lesions in the left parietal lobe and cerebellum which indicated metastasis. Diagnosis: According to the history,physical examination and the radiological finding, the patient was diagnosed with malignant melanoma of central never system possibly. Interventions: The patient underwent left temporal and parietal lesions total resection with a craniotomy. Outcomes: The diagnosis of PDLM was established according to pathological characteristics and the negative finding of positron emission tomography (PET)-computed tomography (CT) outside CNS. The ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research