Malignant transformation of neurocutaneous melanosis (NCM) following immunosuppression

Pediatr Dermatol. 2019 Jul;36(4):497-500. doi: 10.1111/pde.13804. Epub 2019 Mar 13.

Abstract

Neurocutaneous melanosis (NCM) is the condition of abnormal melanocyte deposition in the leptomeninges and brain parenchyma. Associated with congenital melanocytic nevi, NCM can result in neurologic deficits, hydrocephalus, and rarely, malignant transformation of cells. We present the case of a 16-year-old boy with NCM who developed malignant leptomeningeal melanoma following immunosuppression with a TNFα inhibitor. To our knowledge, this is the first reported case of a patient with known NCM undergoing malignant transformation after anti-TNF therapy for inflammatory bowel disease.

Keywords: TNF inhibitor; immunodeficiency; melanocytic nevi; neoplasms-malignant.

Publication types

  • Case Reports

MeSH terms

  • Adalimumab / adverse effects*
  • Adalimumab / therapeutic use
  • Adolescent
  • Cell Transformation, Neoplastic / pathology*
  • Follow-Up Studies
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Inflammatory Bowel Diseases / drug therapy
  • Inflammatory Bowel Diseases / pathology
  • Magnetic Resonance Imaging / methods
  • Male
  • Melanosis / diagnosis
  • Melanosis / pathology*
  • Melanosis / therapy
  • Meningeal Neoplasms / diagnostic imaging
  • Meningeal Neoplasms / secondary*
  • Meningeal Neoplasms / surgery*
  • Neurocutaneous Syndromes / diagnosis
  • Neurocutaneous Syndromes / pathology*
  • Neurocutaneous Syndromes / therapy
  • Nevus, Pigmented / diagnosis
  • Nevus, Pigmented / pathology
  • Nevus, Pigmented / surgery
  • Rare Diseases
  • Risk Assessment
  • Skin Neoplasms / diagnosis
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / therapy
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome

Substances

  • Immunosuppressive Agents
  • Adalimumab

Supplementary concepts

  • Neurocutaneous melanosis