Primary Spinal Malignant Melanoma of Spinal Cord and Conus Medullaris

Abstract

Primary malignant melanoma of the central nervous system is an extremely rare neoplasm and accounts for approximately 1% of all melanoma cases. The occurrence of this lesion in the spinal cord is even rarer.1-3 Magnetic resonance imaging features of melanoma are determinated by the degree of pigment melanin and the presence of acute or chronic hemorrhage and can be easily misdiagnosed with other central nervous system tumors. 2,3 The pathologic examination is critical for proper diagnosis. We report case of primary spinal melanoma. CASE REPORTA 76-year-old man presented with a two month history of progressively worsening bilateral sciatica and weakness in the lower extremities, which failed to respond to medical treatment. Neurological examination revealed a 3/5 muscle power in the Primary Spinal Malignant Melanoma of Spinal Cord and Conus MedullarisGordan Grahovac, Tonko Marinovic, Damir Tomac, Smiljka Lambasa Can J Neurol Sci. 2013; 40: 104-105 BRIEF COMMUNICATIONS lower extremities and all deep tendon reflexes were increased with positive Babinski sign. The sensation of both legs was impaired. There was bladder dysfunction.Magnetic resonance (MR) imaging revealed well defined intramedullary mass arising of the conus medullaris at the level T12 vertebrae. The tumor was hyperintensive on T1-weighted images and hypointensive on T2-weighted images. The spinal cord was slightly swollen adjacent to the upper border of the mass and showing signs of syringomyelia at the T9-T11 level ( Figures 1A, 1B).The patient underwent T11-T12 laminectomy in the prone position. We found subdural well encapsulated black tumor mass which was attached to the conus medullaris. The tumor invaded the central canal of the spinal cord (Figure 2). Unfortunately, because the tumor invaded the central canal we could not