Primary Spinal Melanoma: Case Report and Systematic Review

Haberfellner, Erika; Elbaroody, Mohammad; Alkhamees, Abdullah F.; Alaosta, Abdelfatah; Eaton, Sydney; Quint, Elise; Shahab, Saba; O'Connor, Avalon; Im, Jacob; Khan, Asham; El-Gohary, Yasser; Lotfy, Mohamed; Sawan, Mohamed; Shamisa, Abdalla; Soliman, Mohamed A.R.

doi:10.1016/j.clineuro.2021.106649

Cited by 7 publications

(22 citation statements)

References 56 publications

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“…MRI remains the gold standard for preoperative diagnosis of spinal cord melanoma [ 2 ]. On imaging, melanoma reveals hyperintense and hypointense components on T1 and T2 weighted sequences, respectively, due to the paramagnetic effect of melanin and hemorrhaged foci, hemorrhage causes intermediate signals in melanoma, while increased melanin results in higher intensity on T1-weighted images and lower intensity on T2-weighted images [ 16 , 24 ]. After the addition of contrast, the melanoma manifests as a homogenous enhancement.…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Primary Thoracic Epidural Melanoma

Khalilullah,

Mignucci-Jiménez,

Huffman

et al. 2024

Cureus

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In this study, we reported one of the first cases where a rare robotic-assisted platform with neuronavigation technology and carbon-fiber-polyetheretherketone (CF/PEEK) screws is employed to surgically treat multilevel thoracic primary spinal epidural melanoma. A 67-year-old male presented with left upper thoracic pain. His magnetic resonance imaging (MRI) of the thoracic spine revealed a dumbbell-shaped left epidural mass at the T2-3 level. Partial resection was performed due to tumor growth into the vertebral bodies and patient discretion for minimal surgery. The patient’s neurological conditions improved postoperatively, with reduced reported symptoms of pain and numbness. Postoperative imaging showed evidence of appropriate spinal stabilization. Patient underwent stereotactic body radiation therapy (SBRT), and no adverse events were reported. This case reflects one of the first examples of treating thoracic epidural melanoma with the use of robotic-assisted navigation. Further prospective studies are needed to determine the efficacy of robot-assisted navigation for patients with primary spinal malignant melanoma which may open the possibility of surgery to once presumed non-operative patients.

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Section: Discussionmentioning

confidence: 99%

Surgical Management of Primary Thoracic Epidural Melanoma

Khalilullah,

Mignucci-Jiménez,

Huffman

et al. 2024

Cureus

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“…In most melanomas occurring in the spine, they have primary lesions or metastases in other parts of the spine[ 21 ]. Therefore, the present case adds to the understanding on such melanomas.…”

Section: Discussionmentioning

confidence: 99%

An atypical primary malignant melanoma arising from the cervical nerve root: A case report and review of literture

Shi¹,

Chen²,

Chen³

et al. 2022

WJCC

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BACKGROUND Primary melanomas affecting the central nervous system are very rare, and melanomas originating in the spinal canal or origin of the spinal nerve root are even rarer. As a consequence, not much is known about this. CASE SUMMARY Here we report a case of primary malignant melanoma originating in the cervical spinal cord nerve root. A 64-year-old woman presented with symptoms of numbness in the right side of the neck, pain, and hypoesthesia in the right upper limb which persisted for 1 year. Neurological examination showed that the superficial sensation in the right upper limb had decreased with muscle strength of grade 4. Magnetic resonance imaging examination revealed a mass (approximately 2.5 cm × 1.4 cm × 1 cm) in the right side of the spinal canal in the C-2 plane. Based on findings obtained during operation, perioperative examination, pathological diagnosis, and the diagnostic criteria of primary central melanoma proposed by Hayward, the mass was confirmed to be a melanoma of intraspinal nerve root origin. CONCLUSION This is the first case of primary malignant melanoma originating from cervical spinal cord nerve roots and spread along the inside and outside of the spinal canal. The clinical relevance of this case is discussed to provide new insights into the differential diagnosis of intraspinal tumours. Further studies are needed to better understand the mechanisms driving the growth pattern and development of this type of tumour.

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“…The treatment of primary spinal cord melanoma is controversial and not yet standardized. Generally, surgical resection is recommended; however, total resection of a primary spinal cord melanoma is often difficult and some patients will require postoperative adjuvant treatment, such as radio and chemotherapy 8) . Radiotherapy can be used as an effective adjuvant treatment for primary spinal cord melanoma 9) .…”

Section: Casementioning

confidence: 99%

“…Radiotherapy can be used as an effective adjuvant treatment for primary spinal cord melanoma 9) . Although adjuvant radiation therapy has been used in some reports, the ideal target dose has not been established and it is unclear whether the irradiation should be performed locally or on the whole brain and spinal cord due to the lack of robust data 8) . In our two cases, total resection of the spi-nal cord tumors was performed and the patients were treated with local irradiation.…”

Section: Casementioning

confidence: 99%