Primary melanoma of the leptomeninges.

Primary melanomata of meninges are rare tumours, and well-documented cases rarer still. In 1935 Akelaitis, in a comprehensive review of the literature, collected 29 cases and added one of his own. In 1949 Touraine reviewed all the reported cases of primary pigmented tumours of the meninges; the total was then 66, an addition of only 29 cases in 14 years. Both Akelaitis and Touraine, however, express doubt as to the validity of a number of the reported cases, and Touraine accepts only 27 as being true malignant primary melanomata of the meninges. In that number are included six cases, namely, those of Pol (1905), Weimann (1923), Ehnmark and Jacobowsky (1926), Baumecker (1929), Mackay and Hurteau (1942), Foot and Zeek (1931), case 2, which are unacceptable, as pointed out later, because of the presence of extracranial tumours. Since then six more reports have appeared (Strong, 1947; Pautler and Gallavan, 1951; King, Chambers, and Garey, 1952, two cases; and Russi, Robinson, and Nagler, 1953, two cases). Both the cases of Strong and of Pautler and Gallavan revealed extracranial tumours at necropsy, while Case 2 of Russi et al., as the authors themselves imply, does not fulfil the criteria for the diagnosis of a primary melanoma of the meninges. We thus have a total of only 24 cases in which a diagnosis of primary malignant melanoma of the meninges is considered acceptable. The purpose of this paper is to record another case which, it is believed, is the first one to have been diagnosed in life in Great Britain.