Intramedullary Primary Cervical Melanoma

Abstract

We present an extremely rare case report of a primary intramedullary malignant melanoma arising into the cervical spinal cord. We describe and review clinical presentations, characteristic findings from imaging studies, diagnostic criteria, prognosis, and treatment of primary cervical intraspinal melanoma. A 52-year-old man was presented with numbness in 4 limbs and weakness in both upper limbs. The clinical and radiologic findings were suggestive of malignant process. To preserve the patient's neurologic functions the tumor was subtotally resected. Histopathologic examination demonstrated a malignant melanocytic tumor. Treatment of intramedullary malignant melanoma is difficult. The best treatment should be total surgical excision of the lesion, whenever possible, but removal of the tumor generally is incomplete, and radiation therapy is often recommended after the surgery. It is also important to differentiate whether melanoma is primary or metastases. It has been suggested that primary spinal melanoma exhibits slow progression and the tumor is less aggressive than the more common skin melanoma with central nervous system metastases. Diagnostic criteria and different treatment options for primary and metastatic malignant melanoma is discussed.