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CC BY-NC-ND 4.0 · Asian J Neurosurg 2024; 19(03): 563-566
DOI: 10.1055/s-0044-1787822
Case Report

Primary CNS Melanoma of Meckel's Cave: A Rare Case with Literature Review

Charan Makkina
1   Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
,
Jeena Joseph 
1   Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
,
Krishna Prabhu Raju
1   Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
,
Ranjani Jayachandran 
2   Department of Neuropathology, Christian Medical College, Vellore, Tamil Nadu, India
,
Geeta Chacko
2   Department of Neuropathology, Christian Medical College, Vellore, Tamil Nadu, India
› Author Affiliations Funding None.
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Abstract

Meckel's cave is a dural recess in the posteromedial portion of the middle cranial fossa, serving as a conduit for the trigeminal nerve and hosting various pathologies. The radiological diagnosis of Meckel's cave pathologies is often challenging, especially when they are atypical and rarely encountered. Here, we discuss the case of a 41-year-old woman who presented with right hemifacial pain, numbness, and binocular diplopia. Imaging features suggested a T2 hypointense, T1 hyperintense, and nonenhancing mass in the right Meckel's cave. Intraoperatively, an extra-axial black mass was observed, suggestive of melanoma, which was radically excised. Further postoperative workup and biopsy revealed it was a primary central nervous system (CNS) malignant melanoma, an exceedingly rare condition. Due to the rarity of the disease, a consensus regarding treatment regimens is lacking. This case report underscores the significance of considering uncommon diagnoses when faced with unusual radiological findings and emphasizes the importance of aggressive surgical resection and the evolving landscape of adjuvant treatments for primary CNS melanomas.

Keywords

cavernous sinus - Meckel's cave - primary - CNS - malignant - melanoma

Authors' Contributions

K.R. was responsible for the conception or design of the work. C.M. and J.J. collected the data, while K.R. and G.C. performed the data analysis and interpretation. The article was drafted by C.M., J.J., and R.J., and K.R. conducted the critical revision of the article.




Publication History

Article published online:
13 June 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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