What Tactics Should a Surgeon Choose to Treat a Black Extracerebral Tumor? A Case Report of Psammomatous Melanotic Schwannoma of the Meckel Cave and Literature Review.

Abstract

BACKGROUND:

Neoplasms located in the Meckel cave account for 0.2%-0.5% of all intracranial tumors. This area is the site of many types of pathologic lesions, most often trigeminal nerve schwannomas and meningiomas. Melanin-containing tumors are rare in this area. These tumor types can be suspected if the magnetic resonance characteristics of a tumor has some differences in comparison with other types of central nervous system neoplasms. In fact, differential diagnosis of melanotic tumors is based mainly on the histopathologic criteria and immunohistochemical profile. This article presents a case report of melanotic schwannoma of the Meckel cave and a literature review of the problem.

CASE DESCRIPTION:

A 23-year-old man underwent a 2-stage surgery for a dumbbell pigmented mass lesion located in the Meckel cave. No signs of recurrence were seen on follow-up magnetic resonance imaging (MRI) 3.5 years after the operation.

CONCLUSIONS:

Melanin-containing tumor can be suspected in the presence of radiologic characteristics, such as a hyperintense MRI signal on T1-weighted images and a hypointense signal on T2-weighted images. If a black extracerebral tumor is detected, the main course of surgical treatment is maximal excision despite it possibly being a malignant melanoma and the temptation to perform partial resection because of an unfavorable prognosis. Chemotherapy can be justified in the presence of an aggressive melanotic schwannoma.

• Authors: Galina I Moisak, Dmitry E Matsko, Sergey V Chernov, Aleksandr B Dmitriev, Mikhail E Amelin, Elena A Zhelbunova, Mikhail F Chernov, Jamil A Rzaev
• Journal: World neurosurgery (World Neurosurg) Vol. 116 Pg. 337-342 (Aug 2018) ISSN: 1878-8769 [Electronic] United States
• PMID: 29715570 (Publication Type: Case Reports, Journal Article, Review)
• Copyright: Copyright © 2018 Elsevier Inc. All rights reserved.

Chemical References

• Ki-67 Antigen
• Melanoma-Specific Antigens
• PMEL protein, human
• S100 Proteins
• gp100 Melanoma Antigen

Topics

• Brain Neoplasms (diagnostic imaging, surgery)
• Humans
• Ki-67 Antigen (metabolism)
• Magnetic Resonance Imaging
• Male
• Melanoma (complications, diagnostic imaging, surgery)
• Melanoma-Specific Antigens (metabolism)
• Neurilemmoma (complications, diagnostic imaging, surgery)
• Neurosurgical Procedures (methods)
• S100 Proteins (metabolism)
• Tomography Scanners, X-Ray Computed
• Young Adult
• gp100 Melanoma Antigen