Primary leptomeningeal melanomatosis may mimic other conditions such as lymphomatous, leukemic, or carcinomatosis meningitis, subacute and chronic meningitis
, viral encephalitis, and idiopathic hypertrophic cranial pachymeningitis.
The radiologic appearance suggested chronic meningitis, carcinomatous meningitis, or meningioma; the initial histopathologic impression was also that of a lymphoma.
The clinical presentation of our case suggests that sinus histiocytosis could manifest as meningeal disease, and could mimic meningioma or chronic meningitis.
It occurs in less than 5% of patients and usually presents as acute or chronic meningitis in patients with brucellosis.
We conclude that the diagnosis of neurobrucellosis should be considered in patients presenting with chronic meningitis syndromes with or without cranial nerve involvement and/or myeloradiculopathy from areas endemic for brucellosis.