Congenital malignant melanoma of the dura: a rare entity
This case, published in the journal Applied Radiology describes dural based intracranial and extracranial congenital malignant melanoma, which is an exceptionally rare diagnosis.

A male neonate presented at birth with a subcutaneous mass in the parieto-occipital region. He had an unremarkable birth history. Brain MR imaging at 4 days’ old revealed a large mass with intracranial T1 hyperintensity/T2 hypointensity and extracranial heterogenous T1 hyperintensity/T2 hypointensity with mass effect on the patent superior sagittal sinus and brain parenchyma. CT demonstrated posterior cortical irregularity with posterior scalp edema.

The mass was resected. The mass was identified as dural-based malignant melanoma in the parieto-occipital region. The lesion extended between the sutures into subcutaneous tissue.

The tissue was red-brown with scattered cytoplasmic pigment and extracellular pigment accumulation. Neoplastic cells were positive for S100, HMB-45, and vimentin. The BRAF mutation was not detected. The patient developed numerous hyperpigmented 2- to 3-mm nodular lesions, which were histopathologically identified as malignant melanoma. After resection, the patient began chemotherapy at 3 mo old.

Postoperative brain MRI and CT demonstrated no evidence of intracranial mass, hemorrhage, or hydrocephalus. PET/CT revealed no evidence of metastases. The postoperative midline occipital defect was repaired with cranioplasty. He has met all developmental milestones with no residual neurological deficits.

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