Primary leptomeningeal melanoma. Diagnosis by ultrastructural cytology of cerebrospinal fluid and cranial computed tomography

Cancer. 1982 Nov 1;50(9):1751-6. doi: 10.1002/1097-0142(19821101)50:9<1751::aid-cncr2820500918>;2-q.


A case of primary leptomeningeal melanoma is presented in which the diagnosis was made by ultrastructural demonstration of melanoma cells from the cerebrospinal fluid (CSF) at a time when cranial computed tomography (CT) still gave negative results. Later CT examinations documented the emergence of a tumor mass of the left temporoparietal lobe. This case clearly illustrates the complementary role of these investigational procedures for the diagnosis of cerebrospinal melanoma: leptomeningeal involvement, characterized by two-dimensional diffuse spread of melanoma tissue ("leptomeningeal melanomatosis"), is invisible with CT, but easily recognisable by CSF cytology; in contrast, nodular parenchymal tumor deposits can be readily detected by CT. Identification of pigmented cells recovered from the CSF requires ultrastructural confirmation.

Publication types

  • Case Reports

MeSH terms

  • Brain / diagnostic imaging*
  • Contrast Media
  • Humans
  • Male
  • Melanoma / cerebrospinal fluid*
  • Melanoma / diagnostic imaging
  • Melanoma / ultrastructure
  • Meningeal Neoplasms / cerebrospinal fluid*
  • Meningeal Neoplasms / diagnostic imaging
  • Meningeal Neoplasms / ultrastructure
  • Microscopy, Electron
  • Middle Aged
  • Parietal Lobe
  • Time Factors
  • Tomography, X-Ray Computed


  • Contrast Media