Primary spinal melanoma: case report

Abstract

We report a case of primary melanoma of the thoracic spinal cord revealed by progressive bilateral lower extremity weakness associated with sensory loss and urinary dysfunction. The preoperative MRI revealed an intramedullary tumour from T7 to T9. Treatment was by complete surgical excision without radiotherapy. Histopathology and immuno-histochemical studies confirmed the diagnosis. The postoperative course was satisfactory with no sign of recurrence after 28 months of postsurgical follow-up. Primary spinal melanomas are rare intramedullary tumours that can be cured by appropriate surgical treatment.

Long-Term Survival After Surgical Resection of Primary Spinal Malignant Melanoma -Case Report-

“…Primary CNS malignant melanoma has occurred in the spine, [4][5][6]10,11,19,26) suprasellar region, 3,6,24) cerebral region, 6,7,12,17) pineal region, 18) cerebellopontine angle, 13,25) spinal nerve root, 22,23) and leptomeninges. 16) Forty cases of primary spinal malignant melanoma have been reported, [4][5][6]10,11,19,26) including 14 with dissemination from the primary CNS malignant melanoma.…”

“…16) Forty cases of primary spinal malignant melanoma have been reported, [4][5][6]10,11,19,26) including 14 with dissemination from the primary CNS malignant melanoma. One case had liver and spleen metastases.…”

“…Primary spinal malignant melanoma is unusual, with the first case reported by Hirschberg in 1906, and only 40 cases since then. [4][5][6]10,11,19,26) The prognosis is poor, but primary CNS malignant melanoma including primary spinal malignant melanoma has a better prognosis than cutaneous melanoma. We treated a patient who presented with CNS dissemination 18 years after first treatment for primary spinal malignant melanoma.…”

Primary Spinal Cord Melanoma

“…It is believed that primary melanoma of the spinal cord arises either from leptomeningeal melanoblasts or from neuroectodermal congenital rests 15,22) . Leptomeningeal melanoblasts penetrate the spinal cord with the vascular bundles 5) . Epidermal melanoblasts reach the leptomeninges when the neural crest is formed.…”

“…Complete resection was achieved in 12 cases (46.2%), and subtotal resection was achieved in 14 cases (53.8%). The efficacy of radiotherapy and chemotherapy is still controversial 5,7,14) . Radiotherapy was performed in 11 of 26 patients.…”