Primary Melanocytomas of the Spinal Cord: Case Studies and Rehabilitation Perspectives

Abstract

Primary melanocytomas of the central nervous system are rare tumors arising from leptomeningeal melanocytes. Only 29 cases have been reported in the literature. Presenting symptoms may include insidious onset of back pain, slowly progressive neurologic deficits such as weakness and sensory changes, and bowel and bladder dysregulation. Advanced imaging including magnetic resonance imaging can be helpful in lesion localization but does not distinguish between primary and metastatic melanoma. In this case series, we present 3 patients with nontraumatic spinal cord injuries secondary to primary central nervous system malignant melanocytomas who were admitted to a single inpatient rehabilitation facility within a 12-month time frame. These cases highlight the importance of the rehabilitation team in the continuum of care for patients undergoing resection of primary melanocytomas of the spinal cord. The rehabilitation team should be involved in the preoperative counseling setting, immediately postoperatively, and in follow-up care to assess for signs of recurrence. A comprehensive multidisciplinary approach including physical and occupational therapists, rehabilitation nurses, rehabilitation neuropsychologists, and physiatrists is important for optimizing the function of these patients.

Unsatisfactory Neurological Outcome in an Intramedullary Thoracic Intermediate-Grade Melanocytoma—Systematic Review and Illustrative Case

“…Similarly, Wagner et al described tumor control at eighteen months with fractionated RT administered for a relapse following GTR [13]. However, in the other seven reports, a relapse after GTR was noted during FU MRI, and adjuvant RT was deemed unnecessary [15,[17][18][19]21]. In the cases described by Horn et al [19], despite GTR, recurrence was noted.…”

“…Despite the lack of case reports, it appears that GTR protects from tumor relapse. RT was considered in three cases of tumor relapse, of which two were after GTR [12,13,17]. In the case described by Eskandari et al [12], GTR was achieved of a thoracic intramedullary melanocytoma in a 45-year-old man.…”