Spinal meningeal melanocytoma with extensive dura mater pigmentation: Review of meningeal melanocytic tumors with GNAQ mutations

Meningeal melanocytoma is an extremely rare benign tumor. Although gross total resection of the tumor is the most effective therapy, consensus regarding the management of adjacent pigmented dura mater is lacking. Here, we present a case of meningeal melanocytoma with extensive dura mater pigmentation and discuss the importance of GNAQ mutations in making the diagnosis. A 37-year-old woman presented with bilateral leg weakness. Magnetic resonance imaging revealed a thoracic intradural extramedullary mass. A solid blackish tumor wrapped in dark-pigmented dura mater was excised. No neoplasms were detected in the dura mater or on cerebrospinal fluid analysis. Genetic analysis revealed a GNAQ mutation. The mass was diagnosed as a meningeal melanocytoma. No recurrence was observed during 2 years of follow-up. Histopathological analysis of the dura mater and cytological analysis of the cerebrospinal fluid is useful for deciding whether to administer adjuvant therapy.