Leptomeningeal Melanocytosis and Visual Loss

A 37-year-old male presented to the Emergency Department with a 1-year history of daily headaches and bilateral optic disc swelling. Magnetic resonance imaging (MRI) of the head showed features suggestive of intracranial hypertension. An MRI of the entire spinal cord revealed diffuse leptomeningeal disease. Pathology showed leptomeningeal melanocytosis. The suspected mechanisms of raised intracranial pressure in the setting of spinal cord tumours are discussed. This case is unique given the unusual histologic type of the tumour and the initial presentation suggestive of intracranial hypertension with no myelopathic involvement.