Background: Neurocutaneous Melanosis (NCM) is a rare nonfamilial phakomatosis
characterized by the presence of congenital melanocytic nevi and abnormal melanocyte infiltration
of the leptomeninges.
Objective and Methods: This paper shows the importance of early diagnosis and the most important
imaging features of the disease on CT and MR scans. PubMed database was searched from January
1972 to September 2020. Papers including imaging findings of NCM, clinical, follow-up, and
treatment features were collected, selecting only 89 studies.
Discussion: NCM is a term used for the first time by van Bogaert in 1948. It refers to a condition
caused by an error during morphogenesis and migration leading to leptomeningeal melanocytic accumulation.
Although histological findings are the gold standard for diagnosis confirmation, neuroimaging
and clinical features strongly support the suspect of NCM. Localization and extension of
the lesions are predictive of neurological manifestations related to increased intracranial pressure,
mass lesions, or spinal cord compression. CT demonstrates sites of increased density in the anterior
temporal lobe, mainly the amygdala, thalami, cerebellum, and frontal lobes base. However, MRI is
the best imaging method to diagnose central nervous system lesions, often appearing as T1-short
signal areas of the cerebral parenchyma, indicative of central nervous system melanosis. MRI can
also reveal associated intracranial and intraspinal abnormalities.
Conclusion: Early imaging, when available, is helpful if NCM suspect is raised and may be of guidance
in comparing later studies. NCM requires a multidisciplinary approach since it is a multisystem
disease with a genetic component.