Primary Intradural Extramedullary Melanoma of the Cervical Spinal Cord

Lee, Chang‐Hyun; Moon, Kyung Yun; Chung, Chun Kee; Kim, Hyun-Jib; Chang, Kee-Hyun; Park, Sung Sup; Jahng, Tae-Ahn

doi:10.1097/brs.0b013e3181ccb1b3

Cited by 26 publications

(18 citation statements)

References 20 publications

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“…2 Clinically, PSM of extramedullary origin may be misdiagnosed as a neurogenic tumor (schwannoma), ependymoma, metastatic tumor, hematoma or meningioma. 3,[5][6][7][9][10][11][17][18][19] Ninety percent of melanomas found in the CNS are metastatic tumors. 8 A thorough physical examination is required to rule out melanoma in other organs outside of the spinal cord, before a diagnosis of PSM can be established.…”

Section: Discussionmentioning

confidence: 99%

“…Radiotherapy (from 30 to 60 Gy; median dose: 33.5 Gy) is effective for local control and is reserved for palliation of symptoms due to spinal cord compression or as an adjuvant to laminectomy. 5,6,10,11,17,18,21 Melanoma is also refractory to most systemic chemotherapies. Currently, it has not been confirmed whether postoperative radiotherapy or chemotherapy (such as interferon, methotrexate and temozolomide) has a significant role in overall survival time.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, it has not been confirmed whether postoperative radiotherapy or chemotherapy (such as interferon, methotrexate and temozolomide) has a significant role in overall survival time. 5,6,10,11,17,18,21 Although immunotherapy is the current paradigm shift in management of melanoma, the role of immunotherapy in these rare and particular cases have not yet been documented in the literature.…”

Section: Discussionmentioning

confidence: 99%

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Primary spinal melanoma of extramedullary origin: a report of three cases and systematic review of the literature

et al. 2015

Spinal Cord Ser Cases

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STUDY DESIGN: A review of the literature and three case reports. OBJECTIVES: Primary spinal melanoma (PSM) of extramedullary origin is a rare malignant condition with limited current literature in regards to its clinical course, magnetic resonance imaging (MRI) findings, treatment strategies and prognosis. We reported here three cases of PSM of extramedullary origin. SETTING: China, Guangzhou. METHODS: We report three cases of PSM of extramedullary origin. The clinical and radiological findings of these cases were retrospectively analyzed. RESULTS: The three cases were all of males aged 39, 47 and 76 years, respectively. The duration of their symptoms was 3 weeks, 2 months and 11 months respectively. The extramedullary tumors were all well-defined solitary tumors and were located at C4-5, L2-3 and T9-10, respectively. In one case, involvement of the intervertebral foramen was found. Preoperative MRI showed hyperintense T1W signals and hypointense T2W signals in all three cases and all tumors were clinically misdiagnosed as schwannomas. The patients received total or subtotal resection surgery without radiotherapy or chemotherapy. Patients were alive at 18 months, 27 months and 36 months postoperative follow-up, respectively. CONCLUSION: PSM of extramedullary origin is a rare malignant tumor that shows characteristic findings on MRI. Surgical resection is the preferred treatment strategy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Primary spinal melanoma of extramedullary origin: a report of three cases and systematic review of the literature

et al. 2015

Spinal Cord Ser Cases

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“…PSM was initially reported by Hirschberg in 1906, and accounts for 38% of all CNS melanomas (9). So far, fewer than 60 cases have been reported in the English literature (6,13).…”

Section: Introductionmentioning

confidence: 99%

“…Intermediate-grade melanocytic tumors are not easily classified as melanocytoma or melanoma as they present some histological features associated with aggressive behavior, and moreover, only sporadic cases have been reported in the literature (2,3). To the best of our knowledge, only two cases of multifocal primary melanocytic tumor have been reported in the literature (1,9). In this study, we present a case of multiple spinal cord melanoma located at the level of the cervical and upper thoracic vertebrae, and conduct a review of the pertinent literature.…”

Section: Introductionmentioning

confidence: 99%

Multiple spinal cord melanoma: case report with emphasis on the difficult preoperative diagnosis

Huang

Pan²,

Huang³

et al. 2011

Turkish Neurosurgery

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Primary spinal melanoma (PSM) is rare and usually occurs in the cervical and thoracic regions. Here, we present a case of multiple spinal cord melanoma located at the level of cervical and upper thoracic spine in a 24-year-old male. The patient underwent a T6-T7 thoracic laminectomy and gross-total resection of the duty lesion. The histological findings of the tumor were consistent with an intermediate-grade melanocytoma. To the best of our knowledge, only two cases of multifocal primary melanocytic tumor have been reported in the literature. In this case study we review the pertinent literature and emphasize the importance and difficulties concerning the preoperative diagnosis of multiple PSM. KeywOrds: Primary spinal melanoma, Intermediate-grade, Multiple, Diagnosis ÖZPrimer spinal melanom (PSM) nadirdir ve genellikle servikal ve torasik bölgelerde oluşur. Burada 24 yaşında bir erkekte servikal ve üst torasik omurga seviyesinde oluşmuş bir multipl omurilik melanomu vakasını sunuyoruz. Hastaya T6-T7 torasik laminektomi ve gros total rezeksiyon yapıldı. Tümörün histolojik bulguları orta derece melanositom ile tutarlıydı. Bildiğimiz kadarıyla literatürde sadece iki multifokal primer melanostik tümör vakası bildirilmiştir. Bu vaka çalışmasında ilgili literatürü gözden geçirip multipl PSM preoperatif tanısıyla ilgili zorlukları ve tanının önemini vurguluyoruz.

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Clinical features and long-term outcomes of primary spinal malignant melanoma: a single center experience

Yao

Fang

et al. 2017

J Neurooncol

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Primary malignant melanomas are very rare tumors in the spinal canal. In this study, the authors review their experience in a series of seven patients with histologically proven primary spinal malignant melanoma (PSMM) and discuss the clinical features, treatment strategy, and long-term outcomes. Clinical data of seven patients with PSMM treated at a single institution were retrospectively analyzed. There were three male and four female patients, with a mean age of 44 years. The mean duration of illness was 5.4 months. The tumors showed hyperintensity in six cases on T1-weighted image (WI) and isointensity or hypointensity in five cases on T2WI. Gross total resection (GTR) of the tumor was achieved in two cases, and subtotal resection (STR) was achieved in five cases. Four STR patients underwent postoperative local radiation therapy. Postoperative MRI results showed no tumor recurrence in all four female patients after an average follow-up period of 64.5 months. Three male patients had tumor recurrence and dissemination after postoperative 14.7 months (8-24 months), and all died 16.3 months (10-25 months) after initial diagnosis. PSMM should be considered in the differential diagnosis of a middle-aged patient with spinal lesion if the tumor shows hyperintensity on T1WI and hypointensity or isointensity on T2WI on MRI. STR followed by radiotherapy is not excessively associated with deterioration of the final outcome compared to GTR. Our study suggests that PSMM might have female predominance in favorable outcome. Surgical resection followed by adjuvant radiotherapy and regular follow-up are recommended.

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Primary Intradural Extramedullary Melanoma of the Cervical Spinal Cord

Cited by 26 publications

References 20 publications

Primary spinal melanoma of extramedullary origin: a report of three cases and systematic review of the literature

Primary spinal melanoma of extramedullary origin: a report of three cases and systematic review of the literature

Multiple spinal cord melanoma: case report with emphasis on the difficult preoperative diagnosis

Clinical features and long-term outcomes of primary spinal malignant melanoma: a single center experience

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