TY - JOUR

T1 - 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

AU - Moisak, Galina I.

AU - Matsko, Dmitry E.

AU - Chernov, Sergey V.

AU - Dmitriev, Aleksandr B.

AU - Amelin, Mikhail E.

AU - Zhelbunova, Elena A.

AU - Chernov, Mikhail F.

AU - Rzaev, Jamil A.

N1 - Copyright © 2018 Elsevier Inc. All rights reserved.

PY - 2018/8/1

Y1 - 2018/8/1

N2 - 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.

AB - 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.

KW - Melanin-containing tumor

KW - Melanotic schwannoma

KW - Psammomatous schwannoma

KW - Tumor of Meckel cave

KW - DIAGNOSIS

KW - MANIFESTATION

KW - CARNEY COMPLEX

KW - LESIONS

KW - FEATURES

KW - CT

KW - CENTRAL-NERVOUS-SYSTEM

KW - PATIENT

KW - MENINGEAL MELANOCYTOMA

KW - Brain Neoplasms/diagnostic imaging

KW - Humans

KW - Male

KW - Young Adult

KW - Neurosurgical Procedures/methods

KW - Tomography Scanners, X-Ray Computed

KW - Melanoma-Specific Antigens/metabolism

KW - S100 Proteins/metabolism

KW - Melanoma/complications

KW - Ki-67 Antigen/metabolism

KW - Magnetic Resonance Imaging

KW - Neurilemmoma/complications

UR - http://www.scopus.com/inward/record.url?scp=85049007096&partnerID=8YFLogxK

U2 - 10.1016/j.wneu.2018.04.153

DO - 10.1016/j.wneu.2018.04.153

M3 - Article

C2 - 29715570

AN - SCOPUS:85049007096

VL - 116

SP - 337

EP - 342

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

ER -