Primary diffuse meningeal melanomatosis in a 68-year-old woman

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Presentation transcript:

Primary diffuse meningeal melanomatosis in a 68-year-old woman Primary diffuse meningeal melanomatosis in a 68-year-old woman.A and B, At presentation, contrast-enhanced cranial CT scans show dilatation of the lateral (A) and third (B) ventricles, with effacement of the cerebral convexity sulci (in A). Primary diffuse meningeal melanomatosis in a 68-year-old woman.A and B, At presentation, contrast-enhanced cranial CT scans show dilatation of the lateral (A) and third (B) ventricles, with effacement of the cerebral convexity sulci (in A). Abnormal contrast enhancement is present in the right sylvian fissure (arrow in B) and in the right frontoparietal region.C and D, Twelve months after the placement of a ventricular CSF shunt with a right parietal approach, cranial axial (C) and coronal (D) T1-weighted spin-echo MR images (TR/TE, 580/14) obtained after the intravenous administration of gadopentetate dimeglumine show small lateral and third ventricles and diffuse dural and leptomeningeal enhancement.E, Plain cranial CT scan obtained 1 month before the patient’s death shows tiny ventricles and symmetric areas of hypoattenuation (arrows) in the subinsular white matter and external capsules. This finding was probably due to neoplastic encasing of the penetrating arteries. Maria-Giulia Pirini et al. AJNR Am J Neuroradiol 2003;24:115-118 ©2003 by American Society of Neuroradiology