Pediatric Primary Diffuse Leptomeningeal Melanomatosis: A Rare Case Report and Literature Review of Reported Therapies and Outcomes.

Primary diffuse leptomeningeal melanomatosis (PDLM) is a rare malignant disorder of the central nervous system (CNS) arising from melanocytic cells. Diagnosing PDLM is challenging due to its nonspecific symptoms and overlapping presentation with other CNS pathologies. We describe a rare pediatric patient with PDLM and present a literature review, which identified only 14 pediatric PDLM cases with varied therapeutic approaches and generally poor outcomes. While limited by small numbers and inconsistent reporting, cases treated with combination cranial/spinal radiotherapy and systemic immunotherapy appeared to demonstrate relatively prolonged survival or clinical stability compared with other therapies. Further research and collaboration are essential to establish evidence-based treatment guidelines and improve prognosis in this patient population.