Abstract

Background: Primary CNS melanoma is a rare neoplasm of the brain. Nevus of Ota is an area of macular, melanocytic pigmentation of the sclera and skin around the eye. Association between intracranial melanocytic neoplasms and Nevus of Ota has previously been described in case reports. The two lesions tend to occur ipsilaterally and in Caucasian patients. We present the first documented case of a primary malignant CNS melanoma contralateral to a Nevus of Ota in an African-American patient.

Case Discussion: A 32-year-old female presented with intermittent numbness involving the left side of her face, arm, and leg. General physical exam revealed a large area of hyperpigmentation involving the left side of her face, especially around the eye and upper cheek, consistent with Nevus of Ota. Neuroimaging revealed a hemorrhagic intraparenchymal mass in the right frontotemporal region. Surgical resection of the lesion was performed, and pathology was consistent with primary CNS malignant melanoma.

Conclusion: Primary CNS melanocytic neoplasms and Nevus of Ota share a similar embryological origin. Thus, the associated occurrence of the two is not surprising. We present a unique case of primary CNS malignant melanoma associated with a contralateral Nevus of Ota in an African-American patient. Primary CNS melanoma should be considered in the differential diagnosis of any patient with a Nevus of Ota who is found to have an intracranial mass.

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