Primary Malignant Melanoma of the Lumbar Spine

Abstract

Low Back Pain (LBP) or Lumbago is a leading cause of disability in the United States. There are several etiologies including but not limited to muscle strains, discherniation, vertebral instability and fractures. Most serious however are metastatic neoplastic processes, which invade the spine, spinal cord, and nerve roots potentially causing significant neurologic and functional compromise. Primary tumors of the spine are extremely rare, even rarer are primary melanomas of the spine [1]. We present a rare case of a 55-year-old male that was admitted with unrelenting back pain and inability to ambulate. Imaging shows pathologic L3 vertebral body compression fracture, biopsy confirmed malignant melanoma. Clinical examinations from dermatology, gastroenterology, ophthalmology, and oncology confirmed that there were no primary sources of the malignancy identified resulting in the spinal lesion being the only source and location of the tumor [1]. The patient's radicular symptoms and function improved post-operatively, patient was informed that data of his case will be submitted for publication. However, he later succumbed to a myocardial infarction two years later.

Atypical magnetic resonance imaging findings of a vertebral melanotic melanoma in a dog

“…The final possibility considered was that the vertebral melanoma in our patient could have been a primary neoplasm. In humans, primary vertebral melanoma is incredibly rare, and the authors identified only two case reports in the literature that documented one cervical 34 and one lumbar 35 primary neoplasm. Giuliano et al 36 reported that the primary neoplasm could not be detected in 5.6% of 980 patients with malignant melanoma, and there are a small number of reports of vertebral melanomas suspected to be secondary to an unknown primary neoplasm.…”

“…The final possibility considered was that the vertebral melanoma in our patient could have been a primary neoplasm. In humans, primary vertebral melanoma is incredibly rare, and the authors identified only two case reports in the literature that documented one cervical 34 and one lumbar 35 primary neoplasm. Giuliano et al 36 .…”