Radiation Oncology/CNS/Miscellaneous CNS

Meningeal Melanocytomas
Rare, benign lesions, with high recurrence rate. Thought to be derived from leptomeningeal melanocytes. Contain melanin pigment. Usually positive for HMB 45, Melan A, vimentin, and S-100. May recur as melanomas and may metastasize.


 * Review: PMID 15160350, 2004 &mdash; "Therapy of meningeal melanocytomas." Rades D et al. Cancer. 2004 Jun 1;100(11):2442-7.
 * Reviewed all published literature since 1972. 89 pts included.
 * Demographics: 46 spinal cord, 43 brain. Median f/u 5 yrs.
 * Overall recurrence rate 37%. 24% after complete resection (CTR), 0% after CR + RT, 78% after incomplete resection (ITR), 24% after ITR + RT. For ITR + RT, dose response for local control (86% for 45-55 Gy vs 27% for < 40 Gy)
 * Conclusions: complete resection should be performed when possible. Incomplete resection should be followed with RT, approx 45 Gy.