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Introduction: Cellular blue nevus is an uncommon neoplasm in the spine., Patient Concerns: Here, we present a case of a 24 years old male with a 2 months history of numbness in the right upper limb and shoulder., Diagnosis: Cervical spine and subcutaneous tissue invasive cellular blue nevus., Interventions: The patient underwent C4 laminectomy and partial C3 and C5 laminectomy for total resection of the lesion. Histopathology revealed a nodular tumor with unclear boundaries, which was composed of heavily pigmented dendritic cells and more pigmented spindle cells., Outcomes: There was no recurrence during 3 years follow-up., Conclusion: Invasive cellular blue nevus of the spine can be wrongly diagnosed as spinal meningeal melanocytoma and meningeal melanoma due to its special cell behavior and rarity. Therefore, it is important to understand its pathological and clinical characteristics to avoid over-treatment., Competing Interests: XR and ZK contributed equally to this work.The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

We present a case of spinal meningeal melanocytoma involving the C5 nerve root with spinal cord compression which resembled a neurinoma clinically as well as radiologically. The clinical, radiological and pathological features of this and 11 other cases reported in the literature are reviewed. The significance of correct diagnosis and aggressive surgical management of this benign neoplasm is emphasized.