Primary meningeal melanocytoma of cerebellopontine angle: A case report with 12 years follow up

The authors describe a case of cerebellopontine (CP) angle melanotic lesion in a 38-year-old man who presented with features of CP angle syndrome 12 years ago. Computed tomography scan showed a mass lesion in the left CP angle, which was excised. Biopsy was suggestive of melanoma due to abundance of melanin. After 12 years, he had local recurrence and was re-operated. On reviewing the previous and later biopsy, final diagnosis of melanocytoma was made because of additional finding of absence of mitosis and macronucleoli, which were overlooked in the previous biopsy. Awareness of this finding reduces the possibility of diagnostic error in melanotic tumors. Reliance on the presence of abundance of melanin as the sole criterion for diagnosing melanoma resulted in erroneous diagnosis in our case. The case is discussed in the light of available literature.