Intradural extramedullary metastatic melanoma: A case report and review of the literature

Lockwood, Joseph; Khan, Perwez; Zeoli, Tyler; Maulucci, Christopher M.

doi:10.1016/j.clineuro.2020.106072

Cited by 2 publications

(11 citation statements)

References 14 publications

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“…Lumbar, radicular or cervical pain, urinary dysfunction or incontinence, and loss of thermal sensitivity were other symptoms reported according to the location of the metastasis. 2 The time from the diagnosis of malignant melanoma to the diagnosis of cervical IDEM metastasis was also variable, as reported by Knafo et al, occurring in less than 1 year, and by Shakur et al, after 14 years. 5 In the present case, the time from the diagnosis of melanoma until the patient manifested symptoms of IDEM metastasis was of 6 years.…”

Section: Discussionmentioning

confidence: 89%

“…Among them, the most accepted and which corroborates the fact that most IEMs are associated with other metastases in the CNS is the theory of dissemination through the cerebrospinal fluid (CSF), also called "drop metastases." 2,4 In a review, 8 a rate of positivity of 50% for malignant cells was observed in the CSF analysis. Even though a CSF examination was not performed in the present study during the reported period, the authors agree with its importance, notably when leptomeningeal commitment is a plausible differential diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…However, although the prognosis remains unfavorable, there has been a trend toward better results since 2012 compared with the results observed between 1982 and 1999, which may be related to advances in imaging diagnosis, chemotherapy, and early diagnosis. 2…”

Section: Discussionmentioning

confidence: 99%

“…1 Ocular malignant melanoma occurs in less than 5% of all melanomas, and the liver is the most frequent metastatic site. 2 Studies indicate that early identification of these lesions is the most important factor in terms of prognosis. 1 Such lesions can cause distant metastases, mainly in the lungs, brain, liver, bones, and intestines, most of them with low rates of success regarding treatment.…”

Section: Introductionmentioning

confidence: 99%

“…3 However, intradural extramedullary (IDEM) metastases are exceptionally rare, especially when there is no other metastasis in the central nervous system (CNS). [1][2][3] We herein describe a rare presentation of IDEM metastasis, with an ocular malignant melanoma as the primary site of the lesion. So far, less than ten similar cases have been reported in the literature, and the present report aims to contribute to this context.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Malignant Ocular Melanoma with Intradural Cervical Metastasis: Case Report and Literature Review

Mazzo

Lucca

Alencar

et al. 2022

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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Introduction The occurrence of malignant ocular melanomas is uncommon, and the association of these tumors with intradural extramedullary metastases in the cervical spine is exceptionally rare. Case Report A 62-year-old woman undergoing adjuvant chemotherapy after surgical treatment for malignant ocular melanoma begins to experience vertigo and headache. The condition evolved with walking difficulty and neck pain that was exacerbated by swallowing and mobilizing the neck. During her ocular melanoma follow-up, lesions suggestive of metastasis in the central nervous system were not evidenced until this moment. The physical examination did not show significant findings, and a cranial computed tomography scan was performed. The image showed a hyperdense lesion with postcontrast enhancement inside the vertebral canal, at the level of C1-C2. Spinal decompression and subtotal resection were performed. The anatomopathological report revealed intradural metastasis of a malignant ocular melanoma. The postoperative period was uneventful, with significant pain improvement and no recurrences. Conclusion Intradural extramedullary metastases are rare presentations of malignant ocular melanoma. In addition, less than ten similar cases have been reported in the literature. When caring for a patient with melanoma and neurological deficits, always consider evaluating central nervous system metastases. To evaluate this patient, a sensible and detailed neurological exam is extremely important to recognize the location of the deficits and guide the best approach, such as an indication for surgery.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%