title: Extensive metastatic leptomeningeal melanomatosis as the first clinical sign of a cutaneous melanoma: morphological correlations between magnetic resonance imaging and autopsy findings. A case report.
abstract: In recent years, the diagnosis and management of leptomeningeal carcinomatosis have gained increased attention as patients with neoplasms live longer and the condition becomes more common. Conclusive hallmarks of this disease have yet to be identified. We report and discuss a case of massive invasion of the cerebral leptomeninges by neoplastic cells from a malignant melanoma in a shoulder. Symptoms of cerebral dysfunction were the first indication of neoplasm. The onset of symptoms, magnetic resonance imaging, and patient death all occurred within a brief time span. To our knowledge, this is the first case of meningeal melanomatosis in a patient not treated with chemotherapeutic drugs in which the radiologic evidence is virtually synchronous with direct anatomic observation. Thus the images provided with this report may be of use in the radiographic diagnosis of cerebrospinal metastatic colonization.
authors.affiliation: Department of Pathological Anatomy, University of Trieste, Italy.
authors.forename: Rossana
authors.initials: R
authors.lastname: Bussani
authors.forename: Maria
authors.initials: M
authors.lastname: Cova
authors.forename: Roberto
authors.initials: R
authors.lastname: Pozzi-Mucelli
authors.forename: Debora
authors.initials: D
authors.lastname: Camilot
authors.forename: Furio
authors.initials: F
authors.lastname: Silvestri
mesh_terms: D002540:Cerebral Cortex / Q000503:physiopathology; D017809:Fatal Outcome; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008545:Melanoma / Q000150:complications / Q000556:secondary*; D008577:Meningeal Neoplasms / Q000150:complications / Q000556:secondary*; D008875:Middle Aged; D010291:Paresis / Q000209:etiology; D012878:Skin Neoplasms / Q000150:complications / Q000473:pathology*