Age: 37

Sex: M

Height: 6'1"

Weight: 264

Race: Mexican/Caucasian

Duration of complaint: 3mos

Location: US/brain

Any existing relevant medical issues: Type 2 Diabetes

Pathology report reads: Brain, right frontal, resection: Meningeal melanocytoma.

We have reviewed the 17 slides received for the above patient. Sections show a meningeal neoplasm composed of monomorphic epithelioid cells with abundant heavily pigmented cytoplasm and round vesicular nuclei with prominent nucleoli. There is extensive involvement of Virchow-Robin spaces by lesional cells but no brain invasion. No necrosis present. Only very rare mitotic figures are seen.

Immunohistochemical strains performed at your institution and reviewed at University of Michigan demonstrate that neoplastic cells are positive for HMB-45 and MART-1 and negative for CKAE1/3. Ki-67 proliferation is <1%.

Due to the monomorphic cytology, extremely low proliferative index, and lack of brain invasion, if this specimen represents a single lesion then it is best classified as menigeal melanocytoma. Notably, if this process is multifocal or diffuse, it may be better classified as meningeal melanocytosis. Clinical correlation is suggested.

This case was also reviewed by Drs. **** and ****, dermatopathologists, and shown at Neuropathology Consensus Conference on 10112021.

Help. Doctors are telling me that my husband, who was born with almost head to toe with moles/lesions, is dying. They think that his best course of treatment is chemo/radiation for a condition they know almost nothing about because we're being told it's very rare. One doctor even said he shouldn't have survived childhood. He's currently in a rehab hospital with severe cognitive issues and physical weakness after a craniotomy and then a shunt because of hydrocephalus, both procedures done in a span of less than a month. Help, advice, anything, please. What can we do? What would be our best course of action? Has anyone had any experience with this? Can anyone explain that pathology text to me like I'm five?