Meningeal melanomatosis is an extremely rare malignant melanocytic tumor of the central nervous system characterized by aggressive behavior and major diagnostic challenges. We present a case of a 7-year-old child with rapidly progressive neurological deterioration, including headache, vomiting, transient speech disturbance, seizures, impaired consciousness, and hydrocephalus. At the early stage, the clinical picture suggested meningoencephalitis or a demyelinating disorder; however, lack of response to anti-inflammatory and anti-infective treatment, progressive MRI changes in the brain and spinal cord, and detection of tumor cells in cerebrospinal fluid raised suspicion of meningeal neoplasia. The diagnosis was confirmed by histological and immunohistochemical examination of the biopsy specimen and by immunocytochemical analysis of cerebrospinal fluid. This case highlights the diagnostic value of cerebrospinal fluid cytology in suspected neoplastic involvement of the central nervous system (CNS) meninges.
Evgeniya M. Leonova – Cytopathologist, Clinical Diagnostic Laboratory, Russian Children’s Clinical Hospital — Branch of Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation , Moscow, Russia.
Lilit O. Arakelyan – Cytopathologist, Clinical Diagnostic Laboratory, Russian Children’s Clinical Hospital — Branch of Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation , Moscow, Russia.
Tatyana V. Nikolaeva – Cytopathologist, Clinical Diagnostic Laboratory, Russian Children’s Clinical Hospital — Branch of Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation , Moscow, Russia.
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DOI: 10.14489/lcmp.2026.02.pp.050-056
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