Cerebellopontine Angle Meningeal Melanocytoma: A Rare Case and Literature Review of Outcomes and Recurrences

Melanocytes are neural crest derived cells. Intracranial meningeal melanocytomas (MM) are rare tumors that were first described in 1972. Authors report a rare case of a cerebellopontine (CP) angle MM. In addition, a literature review of CP angle MM is provided and compared with other cranial MMs in terms of recurrence and outcomes. A 45 year old male presented with tinnitus and occipital headache. He had mild sensorineural hearing loss. MRI showed an extra axial CP angle lesion that was hyperintense on T1 and hypointense on T2, with blooming on SWI sequences. A retrosigmoid craniotomy and near total resection was performed. Postoperatively, he developed paresis of the facial and lower cranial nerves, hemiparesis, developed pulmonary complications and died 3 months later. A total of 20 cases of CP angle MM were retrieved and analysed from literature. We noted significant differences between the overall cranial MM and CP angle MM in terms of recurrence and malignant transformation. The recurrence rate was 60%, the higher grade transformation rate was 10%, and mortality was 18%, which was higher than that of cranial MM in general. Authors believe that upfront adjuvant radiotherapy may possibly reduce the recurrence rates in this location.