Magnetic resonance imaging findings in isolated spinal psammomatous melanotic schwannoma

Höllinger, Peter; Godoy, Nelson; Sturzenegger, Mathias

doi:10.1007/s004150050522

Cited by 23 publications

(21 citation statements)

References 8 publications

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“…Histologic examination reveals spindle-shaped Schwann cells in combination with melanosomes of various stages of maturation (63). Psammoma bodies, melanin, and fat can be seen in the psammomatous form of melanotic schwannoma (72). These lesions stain positive for S-100 protein and vimentin, and they stain variably with glial fi brillary acid protein, HMB-45, and other melanocytic markers.…”

Section: Pathologic and Histologic Featuresmentioning

confidence: 96%

Pigmented Lesions of the Central Nervous System: Radiologic-Pathologic Correlation

Smith¹,

Rushing²,

Smirniotopoulos³

2009

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163

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Pigmented lesions of the central nervous system (CNS) are a diverse group of entities that run the gamut from benign to malignant. These lesions may be well circumscribed or diffuse, and their imaging appearances are influenced by the degree of melanin content as well as the presence or absence of hemorrhage. Pigmented lesions include primary melanocytic lesions of the CNS and metastatic melanoma, as well as other CNS neoplasms that may undergo melanization, including schwannoma, medulloblastoma, and some gliomas. Primary melanocytic lesions of the CNS arise from melanocytes located within the leptomeninges, and this group includes diffuse melanocytosis and meningeal melanomatosis (seen in neurocutaneous melanosis), melanocytoma, and malignant melanoma. Primary melanin-containing lesions of the CNS must be differentiated from metastatic melanoma because these lesions require different patient workup and therapy. Absence of a known primary malignant melanoma helps in the differential diagnosis, but an occult primary lesion outside the CNS must be sought and excluded. Pigmented lesions of the CNS are uncommon, and knowledge of their imaging characteristics and pathologic features is essential for their identification.

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Section: Pathologic and Histologic Featuresmentioning

confidence: 96%

Pigmented Lesions of the Central Nervous System: Radiologic-Pathologic Correlation

Smith¹,

Rushing²,

Smirniotopoulos³

2009

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163

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“…However, there can be some difficulty in differentiating subacute hematomas from melanotic lesions since they share similar characteristics on MRI. 15 This is what most likely led to the initial radiographic diagnosis of cavernous malformation in our case.…”

Section: Discussionmentioning

confidence: 59%

Intramedullary Melanotic Schwannoma

Hoover¹,

Bledsoe²,

Giannini

et al. 2012

Rare Tumors

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We present a case of an intramedullary melanotic schwannoma (IMS) of the thoracic spinal cord. To our knowledge, this is the seventh reported case of an IMS of the central nervous system. Schwannomas are benign nerve sheath tumors of neural crest origin composed entirely of well differentiated Schwann cells that typically occur in peripheral nerves. Both the intramedullary location and the melanotic component of the reported lesion make it exceedingly rare. We will present our case, theories as to the origin of these tumors, clues in radiographic identification, and current clinical follow-up recommendations.

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“…Preoperative diagnosis is mainly based on MRI. While conventional schwannomas are hypointense on T1-weighted and hyperintense on T2-weighted sequences, melanotic schwannomas are hyperintense on T1-weighted and hypointense on T2-weighted sequences 11 12. Appropriate long-term follow-up is required for all SMS, as it may recur or metastasize after more than 5 years, even in the absence of overt malignant histological features 2 13…”

Section: Discussionmentioning

confidence: 99%

Spotty skin pigmentation and multiple blue naevi as cutaneous markers for spinal melanotic schwannoma

2014

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SUMMARYSpinal melanotic schwannomas are rare spinal tumours with a very poor prognosis in terms of mortality due to difficulty in complete resection and local recurrences. A 67-year-old man presented with acute onset progressive paraparesis for 2 weeks. The patient also had spotty skin pigmentations (blue naevi) in his right lateral thigh. MRI revealed an intradural extramedullary enhancing lesion in the lower thoracic cord level. With a preoperative diagnosis of simple nerve sheath tumour excision was planned. At laminotomy, an infiltrating "en plaque" like lesion reaching up to mid and upper thoracic cord level was identified and excision was carried out. Postoperative histopathology was unique with the identification of melanin and presence of epitheloid cells, with the additional detection of psammoma bodies and adipose-like cells. Melanotic schwannomas though rare and carry poor prognosis must be borne in mind in patients with spotty skin pigmentation and acute onset limb weakness. BACKGROUND

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Magnetic resonance imaging findings in isolated spinal psammomatous melanotic schwannoma

Cited by 23 publications

References 8 publications

Pigmented Lesions of the Central Nervous System: Radiologic-Pathologic Correlation

Pigmented Lesions of the Central Nervous System: Radiologic-Pathologic Correlation

Intramedullary Melanotic Schwannoma

Spotty skin pigmentation and multiple blue naevi as cutaneous markers for spinal melanotic schwannoma

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