An Uncommon Case of Primary Leptomeningeal Melanoma in a 66-Year-Old White Caucasian Male

Primary melanocytic tumors of the central nervous system (CNS) arise from leptomeningeal melanocytes and possess a variable degree of aggressiveness. They have been classified into melanomatosis, melanocytoma, malignant melanoma, and diffuse melanocytosis. Melanocytic lesions of the CNS include both benign (leptomeningeal melanocytosis, melanocytoma) and malignant (leptomeningeal melanomatosis, melanoma) pathologies and the extent of anatomical site involvement dictates their clinical features. Primary CNS melanoma accounts for approximately 1% of all melanoma cases with a peak incidence in the fourth decade. Though the most common location of occurrence is in the lumbar region, our patient presented with a thoracolumbar lesion. We present a case of a 66-year-old white Caucasian male who presented with complaints of headache for six months and was thoroughly evaluated leading to a rare diagnosis of primary leptomeningeal melanoma.