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Intracranial invasion of cellular blue nevus (CBN) from the skin is extremely rare
and such a condition with malignant transformation is even rarer. A case of
meningeal melanoma with malignant transformation which was derived from an Ota
nevus is presented in this report.
A21-year-old man with a neurocutaneous syndrome since childhood was referred
with headache and mild left hemiparesia. CT scan and MRI demonstrated intracranial
lesions and conjunctival biopsy leads to the pathologic diagnosis of blue nevus.
Thereafter his parietal lesion was operated by craniotomy with total gross excision.
On histopathological examination, diagnosis of malignant melanoma was confirmed.
Approximately 2 months after radiotherapy and chemotherapy, he afflicted to
diplopia and blurred vision on the leftside due to enlargement of orbital and cavernous
sinus lesion. Following one year follow-up, he was survived and thrived with
diffuse leptomeningeal nodular enhancement in favor of melanoma dissemination.
Primary intracranial melanomas are though rare, but it should be suspected especially
in the presence of periorbital blue nevus or nevus of Ota. Moreover, although CBN
is considered benign, scalp or periorbital CBN has the potential for intracranial invasion and malignant transformation.
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