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Unusual tonsillar herniation in meningeal melanocytoma: a case report.

Samimi K, Gharib MH, Rezaei-Kalantari K, Jafari M - Iran J Radiol (2012)

Bottom Line: In a 38-year-old man with a complaint of headache for a couple of years and recently added nausea, vomiting, diplopia, progressive visual blurring and hearing loss, magnetic resonance imaging (MRI) was remarkable for T1 shortening of leptomeninges and certain nodules in precontrast study.Subsequent contrast-enhanced MR imaging of the brain and spine revealed enhancement in the basal cisterns extending throughout the spinal canal.The characteristic shortening of T1 and T2 relaxation times in MRI as a result of the paramagnetic stable free radicals that exist within melanin, often suggests a diagnosis of a melanocytic leptomeningeal process.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Rasoul-e-Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran.

ABSTRACT
Meningeal melanocytoma is a primary melanocytic neoplasm with certain MR and immunohistochemical characteristics worthy to note. In a 38-year-old man with a complaint of headache for a couple of years and recently added nausea, vomiting, diplopia, progressive visual blurring and hearing loss, magnetic resonance imaging (MRI) was remarkable for T1 shortening of leptomeninges and certain nodules in precontrast study. Subsequent contrast-enhanced MR imaging of the brain and spine revealed enhancement in the basal cisterns extending throughout the spinal canal. Contrast-enhanced MRI revealed diffuse enhancement in the basal cisterns extending throughout the spinal canal. Immunohistochemical analysis on one of the intraspinal nodules proposed leptomeningeal melanocytoma. The characteristic shortening of T1 and T2 relaxation times in MRI as a result of the paramagnetic stable free radicals that exist within melanin, often suggests a diagnosis of a melanocytic leptomeningeal process. Moreover, there are unique immunohistochemical characteristics for these varied lesions. In appropriate clinical settings, certain radiologic findings, especially both T1 and T2 shortening in nodular CNS lesions should propose meningeal melanocytoma.

No MeSH data available.


Related in: MedlinePlus

A, Mid-sagittal T1-weighted image through the cervical and upper thoracic region is remarkable for hypersignal leptomeningeal lesions of melanocytoma as a result of T1 shortening effect of their melanin content; B, Mid-sagittal contrast enhanced T1-weighted image is brought in the corresponding level, revealing contrast enhancement in the aforementioned lesions.
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fig566: A, Mid-sagittal T1-weighted image through the cervical and upper thoracic region is remarkable for hypersignal leptomeningeal lesions of melanocytoma as a result of T1 shortening effect of their melanin content; B, Mid-sagittal contrast enhanced T1-weighted image is brought in the corresponding level, revealing contrast enhancement in the aforementioned lesions.

Mentions: Noncontrast head CT scan showed hyperattenuated foci in both temporal and occipital lobes, basal meninges and the cerebellum (Figure 1). Meanwhile, diffuse leptomeningeal enhancement and multiple well-enhanced nodules along basal cisterns and posterior fossa surface were noted in contrast-enhanced CT scan. Magnetic resonance imaging (MRI) was remarkable for T1 shortening of the leptomeninges and corresponding nodules in precontrast study (Figure 2). Subsequent contrast-enhanced MR imaging of the brain and spine revealed enhancement in the basal cisterns extending throughout the spinal canal (Figure 3). One of the symptomatic intraspinal nodules was resected and surgical specimens consisting of several leptomeningeal- based fragments of soft brown tissue were submitted for pathological study. Gross features were not characteristic for any particular type of meningeal tumor. Light microscopic examination showed the appearance of a neoplastic pigmented lesion. Eventually, immunohistochemical analysis was reactive for S-100 protein, HMB-45 and vimentin, proposing leptomeningeal melanocytoma.


Unusual tonsillar herniation in meningeal melanocytoma: a case report.

Samimi K, Gharib MH, Rezaei-Kalantari K, Jafari M - Iran J Radiol (2012)

A, Mid-sagittal T1-weighted image through the cervical and upper thoracic region is remarkable for hypersignal leptomeningeal lesions of melanocytoma as a result of T1 shortening effect of their melanin content; B, Mid-sagittal contrast enhanced T1-weighted image is brought in the corresponding level, revealing contrast enhancement in the aforementioned lesions.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3569558&req=5

fig566: A, Mid-sagittal T1-weighted image through the cervical and upper thoracic region is remarkable for hypersignal leptomeningeal lesions of melanocytoma as a result of T1 shortening effect of their melanin content; B, Mid-sagittal contrast enhanced T1-weighted image is brought in the corresponding level, revealing contrast enhancement in the aforementioned lesions.
Mentions: Noncontrast head CT scan showed hyperattenuated foci in both temporal and occipital lobes, basal meninges and the cerebellum (Figure 1). Meanwhile, diffuse leptomeningeal enhancement and multiple well-enhanced nodules along basal cisterns and posterior fossa surface were noted in contrast-enhanced CT scan. Magnetic resonance imaging (MRI) was remarkable for T1 shortening of the leptomeninges and corresponding nodules in precontrast study (Figure 2). Subsequent contrast-enhanced MR imaging of the brain and spine revealed enhancement in the basal cisterns extending throughout the spinal canal (Figure 3). One of the symptomatic intraspinal nodules was resected and surgical specimens consisting of several leptomeningeal- based fragments of soft brown tissue were submitted for pathological study. Gross features were not characteristic for any particular type of meningeal tumor. Light microscopic examination showed the appearance of a neoplastic pigmented lesion. Eventually, immunohistochemical analysis was reactive for S-100 protein, HMB-45 and vimentin, proposing leptomeningeal melanocytoma.

Bottom Line: In a 38-year-old man with a complaint of headache for a couple of years and recently added nausea, vomiting, diplopia, progressive visual blurring and hearing loss, magnetic resonance imaging (MRI) was remarkable for T1 shortening of leptomeninges and certain nodules in precontrast study.Subsequent contrast-enhanced MR imaging of the brain and spine revealed enhancement in the basal cisterns extending throughout the spinal canal.The characteristic shortening of T1 and T2 relaxation times in MRI as a result of the paramagnetic stable free radicals that exist within melanin, often suggests a diagnosis of a melanocytic leptomeningeal process.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Rasoul-e-Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran.

ABSTRACT
Meningeal melanocytoma is a primary melanocytic neoplasm with certain MR and immunohistochemical characteristics worthy to note. In a 38-year-old man with a complaint of headache for a couple of years and recently added nausea, vomiting, diplopia, progressive visual blurring and hearing loss, magnetic resonance imaging (MRI) was remarkable for T1 shortening of leptomeninges and certain nodules in precontrast study. Subsequent contrast-enhanced MR imaging of the brain and spine revealed enhancement in the basal cisterns extending throughout the spinal canal. Contrast-enhanced MRI revealed diffuse enhancement in the basal cisterns extending throughout the spinal canal. Immunohistochemical analysis on one of the intraspinal nodules proposed leptomeningeal melanocytoma. The characteristic shortening of T1 and T2 relaxation times in MRI as a result of the paramagnetic stable free radicals that exist within melanin, often suggests a diagnosis of a melanocytic leptomeningeal process. Moreover, there are unique immunohistochemical characteristics for these varied lesions. In appropriate clinical settings, certain radiologic findings, especially both T1 and T2 shortening in nodular CNS lesions should propose meningeal melanocytoma.

No MeSH data available.


Related in: MedlinePlus