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脳神経外科速報
Abstract
Intracranial meningeal melanocytomas are rare benign tumors, accounting for 0.06-0.1% of all brain tumors. We report a rare case of meningeal melanocytoma with a parietal blue nevus. A 30-year-old man presented with headache and dysarthria. Computed tomography revealed a 4×5×5cm tumor on the parietal lobe with edema. Magnetic resonance imaging(MRI) revealed a lesion of iso-hyperintensity on T1-weighted imaging and hypointensity on T2-weighted FLAIR imaging. During the surgery, we found a blue nevus on his parietal scalp. The dura also had deep pigmentation. The tumor was completely removed with the overlying dura. Histological examination revealed a melanocytoma without aggressive features. Immunohistological stainings for Melan-A, and HMB-45, were positive. The MIB-1 staining index was 4-5%. Pigmentation and melanocytes, but no tumor cells, were observed in the dura. After the operation, he was well without neurological deficits. MRI with gadolinium enhancement revealed a complete tumor resection. Intracranial meningeal melanocytoma with a blue nevus is rare. The overlying dura on the tumor may have pigmentation, as in our case. However, we did not see any tumor invasion in the dura. The patient is doing well without recurrence after 3.3 years. Melanocytoma combined with an overlying nevus is so rare, that clinical differences from the tumor without nevus remains to be elucidated.
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