Primary Intracranial Melanoma Presenting as a Suprasellar Tumor

A 37-year-old white woman presented with progressive visual loss in the right eye. The diagnostic evaluation suggested a tumor in the suprasellar area. At operation an isolated melanoma was found just superior to the sella turcica. No evidence of other intracranial lesions was present and complete diagnostic studies failed to reveal any other primary site. The patient subsequently underwent a second neurosurgical procedure in an effort to remove the tumor completely. This was followed by recurrent symptomatology and she was then treated with a combination of multiple drug chemotherapy and immunotherapy. Approximately 3 years after her initial operation the patient succumbed secondary to her disease. The autopsy findings were consistent with a primary melanoma of the leptomeninges in the area just above the sella turcica. This unusual presentation is discussed and plausible hypotheses are given.