To highlight the diagnostic challenges and clinical significance of amelanotic primary diffuse leptomeningeal melanocytosis (PDLM) and its presentation mimicking subarachnoid hemorrhage (SAH).
Key Findings:
Amelanotic PDLM can mimic SAH and inflammatory meningitis on imaging.
Absence of T1 hyperintensity on MRI complicates diagnosis.
Histopathological confirmation is crucial for accurate diagnosis.
Early intervention is critical to improve patient outcomes.
Interpretation:
The case underscores the need for heightened awareness of amelanotic PDLM in young patients presenting with unexplained leptomeningeal enhancement and negative angiograms, emphasizing the potential for misdiagnosis.
Limitations:
The rapid clinical deterioration limited the initiation of targeted therapy, highlighting the need for timely diagnosis.
The case represents a single patient experience, which may not be generalizable, underscoring the rarity of PDLM.
Conclusion:
Early biopsy and molecular profiling are essential for timely diagnosis and treatment planning in cases of suspected amelanotic PDLM, particularly in patients with atypical presentations.
