Primary Spinal Cord Melanoma – An Uncommon Entity

Chatterjee, Ritodhi; Nascimento, Fábio A.; Heck, Kent A.; Ropper, Alexander E.; Sabichi, Anita L.

doi:10.1017/cjn.2019.28

Cited by 9 publications

(13 citation statements)

References 6 publications

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“…2 To our knowledge, since then, <70 cases of primary spinal cord melanoma have been reported worldwide. 3 Most spinal melanomas discovered occur due to metastatic spread from the skin, uvea, or gastrointestinal or vaginal mucosa. 3 However, melanomas can occur in any anatomical site that contains melanocytes, including the central nervous system (CNS).…”

Section: Discussionmentioning

confidence: 99%

“…3 Most spinal melanomas discovered occur due to metastatic spread from the skin, uvea, or gastrointestinal or vaginal mucosa. 3 However, melanomas can occur in any anatomical site that contains melanocytes, including the central nervous system (CNS). 4 Observations Primary CNS melanomas account for 1% of all melanomas, with the incidence of primary spinal cord melanoma being even rarer.…”

Section: Discussionmentioning

confidence: 99%

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Primary spinal melanoma: illustrative case

House

Archer

Bradbury

2021

Journal of Neurosurgery: Case Lessons

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BACKGROUND Primary spinal melanoma is extremely rare, accounting for ∼1% of all primary melanomas. Typically presenting insidiously in the thoracic spinal cord, primary spinal melanomas can have an acute presentation due to their propensity to hemorrhage. OBSERVATIONS Despite its rarity, primary spinal melanoma should be included in the differential diagnosis when a hemorrhagic pattern of T1 and T2 intensities is seen on magnetic resonance imaging. Furthermore, the complete diagnosis is crucial because the prognosis of a primary spinal melanoma is considerably more favorable than that of a primary cutaneous melanoma with metastatic spread. LESSONS Resection is the treatment of choice, with some authors advocating for postoperative chemotherapy, immunotherapy, and/or radiation. We describe a case of acute quadriplegia from hemorrhagic primary spinal melanoma requiring resection.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Primary spinal melanoma: illustrative case

House

Archer

Bradbury

2021

Journal of Neurosurgery: Case Lessons

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“…The CT however showed a hyperdense lesion in the conus, suggestive of hemorrhage. [ 1 ] Subsequent surveillance imaging is also recommended looking for recurrence of tumors and/or metastatic disease (e.g., MR, CT, and PET-CT)…”

Section: Discussionmentioning

confidence: 99%

“…Postoperatively, it is imperative to carry out dermatological, ophthalmological, and gastrointestinal examinations, along with a PET scanning to determine whether the intramedullary mass was primary or metastatic. [ 1 , 2 ]…”

Section: Discussionmentioning

confidence: 99%

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An uncommon intramedullary tumor: Primary medullary cone melanoma

Nogueira

Cardoso

Fonseca

et al. 2020

Surgical Neurology International

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Background: Melanoma is the third most common primary tumor to metastasize to the central nervous system (CNS). However, primary CNS melanoma is very rare, and primary intramedullary melanoma is even less frequently encountered, with only 27 cases published in the literature. There are no pathognomonic imaging characteristics, therefore, the diagnosis must be confirmed immunohistologically and the preferred treatment is the gross total resection. Case Description: A 68-year-old male presented with low back pain of 2 months duration, and 1 week of urinary retention/anal sphincter incontinence. The neurologic examination revealed bilateral paraparesis (3/5 level) with bilateral Babinski signs, and a T10–T11 pin level. The lumbar CT-Scan showed a hyperdense intramedullary tumor arising from the conus medullaris. The patient underwent a D12–L2 laminectomy with myelotomy for gross-total tumor resection. Postoperatively, he regained motor function but the urinary incontinence remained unchanged. The diagnosis of a primary malignant melanoma was confirmed both histopathologically and immunohistochemically (e.g., staining revealed positive immunoreactivity for S100 protein and Melan A). Conclusions: Primary intramedullary spinal melanoma is very rare, and the diagnosis must be biopsy/operatively confirmed. Whether gross total resection is feasible depends on the extent of tumor infiltration of the cord/ adherence as well as the potential for clinical deterioration with overly aggressive removal.

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