Primary meningeal melanoma with cerebrospinal fluid dissemination mimicking neurofibromatosis type 2.

A 38-year-old man admitted with headache, left paresis and bilateral sensorineural hearing loss. Neuroimaging showed a peripheral frontal tumor with hyperintensity on T1WI and bilateral internal auditory canal (IAC) lesions. (Figures 1, 2 and 3). The presence of hyperintensity on T1WI, without fat or hemorrhage should direct for lesions containing melanin1. Resection of the frontal tumor diagnosed a primary malignant meningeal melanoma with cerebrospinal fluid dissemination once the patient has no melanocytic lesions outside the CNS. The melanocytic lesions ranges from melanocytoma to melanoma2,3,4,5. Malignant melanoma should be included in the differential diagnosis of neoplastic CSF dissemination with bilateral IAC lesions mimicking schwannomas in NF2.