Images in Neurology |

Symptomatic Neurocutaneous Melanosis in a Child

Puneet Jain, MD; Lakshminarayanan Kannan, MD; Atin Kumar, MD; Elanthenral Sigamani, MD; Vaishali Suri, MD; Noufal Basheer, MCh; Ashish Suri, MCh; Sheffali Gulati, MD
JAMA Neurol. 2013;70(4):516. doi:10.1001/jamaneurol.2013.2230.
Text Size: A A A
Published online


A 3-year-old boy presented with focal seizures for 3 months. He had severe headache associated with nonprojectile vomiting. There was no history of altered sensorium or diminished vision. He was developmentally normal. Family history was unremarkable. The patient was irritable. There was a giant congenital nevus in “bathing-trunk” distribution with multiple satellite nevi (Figure 1A). There was atrophy of the left leg. There were no focal motor or sensory deficits. Muscle stretch reflexes were normal. The rest of the neurological and systemic examination was unremarkable.

Figures in this Article

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Graphic Jump Location

Figure 1. A child with neurocutaneous melanosis. A, Giant congenital nevus in “bathing-trunk” distribution with multiple satellite nevi. B and C, T1 (B)- and T2 (C)-weighted axial magnetic resonance imaging of the brain at the level of the pons shows a parenchymal lesion in the left medial temporal lobe (arrows) that is hyperintense on T1-weighted imaging and heterogenous with areas of hypointensity on T2-weighted imaging. The lesion in the pons is hyperintense on T1-weighted imaging (arrowhead in part B) and isointense on T2-weighted imaging.

Place holder to copy figure label and caption
Graphic Jump Location

Figure 2. Histopathology of the surgical specimen. A, Hematoxylin-eosin stain (original magnification ×400) shows an infiltrative neoplasm with irregular nests of closely packed malignant cells, some of which contain intracytoplasmic melanin (large arrow) and mitotic figures (small arrows). B, HMB-45 staining shows strong immunoreactivity (original magnification ×400). C, S-100 staining shows positive nuclear staining of the tumor cells (original magnification ×200).




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Related Topics
PubMed Articles
Giant congenital melanocytic nevus. An Bras Dermatol 2013 Nov-Dec;88(6):863-78.