title: Multifocal melanocytoma of the posterior fossa and subcutaneous scalp in the absence of neurocutaneous melanosis.
abstract: BACKGROUND
  Primary leptomeningeal melanocytic neoplasms of the central nervous system are rare. Multifocal lesions typically occur in the setting of cutaneous melanosis. We present the first report of a posterior fossa melanocytoma and subcutaneous melanocytoma of intermediate grade in the absence of cutaneous melanosis.
  
  
  METHODS
  We present the case of a 22-year-old male with decreased hearing on the right side, ataxia, nausea, vomiting and a scalp mass. Magnetic resonance imaging (MRI) demonstrated occipital and cerebellopontine (CP) angle masses. The patient underwent gross total resection of the scalp mass and subtotal resection of the CP angle mass. Pathologic examination revealed melanocytoma with intermediate grade. The patient underwent stereotactic radiosurgery to the residual CP angle tumor. This case represents, to the author's knowledge, the first report associating a posterior fossa melanocytoma with a subcutaneous melanocytoma of intermediate grade in the absence of cutaneous melanosis.
  
  
  CONCLUSIONS
  This case introduces the first report of a new variant of multifocal melanocytoma which is not confined to the central nervous system.
authors.affiliation: Department of Neurosurgery, Saint Louis University, Saint Louis, Missouri, USA.
authors.forename: Matt
authors.initials: M
authors.lastname: Pierson
authors.affiliation: Department of Pathology, Saint Louis University, Saint Louis, Missouri, USA.
authors.forename: Nitin
authors.initials: N
authors.lastname: Marwaha
authors.affiliation: Department of Pathology, Saint Louis University, Saint Louis, Missouri, USA.
authors.forename: Miguel
authors.initials: M
authors.lastname: Guzman
authors.affiliation: Department of Otolaryngology, Saint Louis University, Saint Louis, Missouri, USA.
authors.forename: Anthony A
authors.initials: AA
authors.lastname: Mikulec
authors.affiliation: Department of Neurosurgery, Saint Louis University, Saint Louis, Missouri, USA.
authors.forename: Jeroen R
authors.initials: JR
authors.lastname: Coppens
keywords: Multifocal melanocytoma meningeal melanosis; radiosurgery; subcutaneous melanocytoma