Primary Spinal Melanoma Research Articles

Primary spinal melanoma: A radiological diagnostic dilemma confirmed by histopathology

Primary malignant melanoma of central nervous system accounts for approximately 1% of all melanomas. Primary spinal melanomas are even more unusual. The clinico-radiological features of primary spinal melanoma are complex and non-specific, resulting in a high misdiagnosis rate. Here, primary cervico-thoracic spinal melanoma is presented in a 53-year-old woman which mimicked a hematoma on magnetic resonance imaging and an arteriovenous malformation intraoperatively. Histopathology and immunohistochemistry confirmed the diagnosis of malignant melanoma.

Primary Spinal Cord Melanoma – An Uncommon Entity

Primary Spinal Cord Melanoma – An Uncommon Entity

A rare case of primary intradural spinal melanoma presenting with a cauda equina syndrome

A rare case of primary intradural spinal melanoma presenting with a cauda equina syndrome

Primary cervical spine melanoma

Primary spinal melanoma is too rare to have any systemic statistical data on the epidemiology of this disease. We report a 58-year-old woman presented with spastic gait for 10 days, preceded by chronic pain at her left anterior chest that progressively spread to her neck, left shoulder, and arm in half a year. Cervical magnetic resonance imaging (MRI) displayed a well-enhancing focal intraspinal extramedullary tumor at C6/7 level. After surgical resection of the tumor and thorough studies to exclude extraspinal melanoma, the primary spinal melanoma is diagnosed. Postoperative MRI did not disclose any evidence of recurrence at 4 and 21 months later. We present the clinical, radiological, and pathological features of a patient with a primary cervical extramedullary spinal melanoma.

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

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.

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

A review of the literature and three case reports. 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. China, Guangzhou. We report three cases of PSM of extramedullary origin. The clinical and radiological findings of these cases were retrospectively analyzed. 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. PSM of extramedullary origin is a rare malignant tumor that shows characteristic findings on MRI. Surgical resection is the preferred treatment strategy.

Primary extramedullary spinal melanoma mimicking spinal meningioma: A case report and literature review.

Primary spinal melanoma is a rare lesion, which occurs throughout the cranial and spinal regions, however, is primarily observed in the middle or lower thoracic spine. The clinical features of primary spinal melanoma are complex and unspecific, resulting in a high misdiagnosis rate. In the present case report, a rare case of spinal melanoma exhibiting the dural tail sign and mimicking spinal meningioma is reported. The initial diagnosis, using magnetic resonance imaging (MRI), was unclear. Thus, melanin-containing tumors and spinal meningioma should have been considered in the differential diagnosis. The tumor was completely resected using a standard posterior midline approach, which was followed by chemotherapy. Subsequent to the surgery, the patient was discharged with improved motor capacity and a follow-up MRI scan showed no recurrence after six months. The present study demonstrates that it is critical for neurosurgeons to focus on increasing the accuracy of initial diagnoses in order to make informed decisions regarding the requirement for surgical resection. The present case report presents the clinical, radiological and pathological features of primary extramedullary spinal melanoma mimicking spinal meningioma to emphasize the importance of early identification and diagnosis.

Primary Cervical Intramedullary Spinal Cord Melanoma

Primary Cervical Intramedullary Spinal Cord Melanoma

Management preferences and prognosis for primary intracranial melanocytic neoplasms

Background: Contrary to relatively frequent metastatic melanoma, primary melanocytic CNS neoplasms are rare, coming up from melanocytes situated in the leptomeninges. These lesions incorporate diffuse meningeal melanomatosis, melanin-pigmented meningioma, well-differentiated benign melanocytoma, and primary malignant intracranial and/or spinal melanoma.

Primary Spinal Malignant Melanoma of Spinal Cord and Conus Medullaris

Primary Spinal Malignant Melanoma of Spinal Cord and Conus Medullaris

Primary Melanoma of the Cervical Spine with Cerebral Metastases: Case Report and Review of the Literature

Primary spinal melanoma is a very rare condition: to date < 60 cases have been reported in the literature. A 48-year-old man presented with a 6-month history of upper- and lower-extremity numbness. Spinal magnetic resonance imaging (MRI) revealed a space-occupying lesion at the C2-C6 level. This was confirmed as a melanoma by immunohistochemistry. Cerebral MRI showed multiple lesions with the same signal characteristics as those seen in the spinal lesion on MRI. Complete skin, mucosal and retinal examination failed to show any primary lesion, therefore a diagnosis of primary cervical melanoma with brain metastases was made. To our knowledge this is the first report of a primary melanoma of the cervical spine with cerebral metastases at the time of diagnosis. This article presents pertinent reported literature and discusses the aetiology, diagnosis, treatment and prognosis of this unusual condition.

Low back pain as the presenting sign in a patient with primary extradural melanoma of the thoracic spine - A metastatic disease 17 Years after complete surgical resection

Primary spinal melanomas are extremely rare lesions. In 1906, Hirschberg reported the first primary spinal melanoma, and since then only 40 new cases have been reported. A 47-year-old man was admitted suffering from low back pain, fatigue and loss of body weight persisting for three months. He had a 17-year-old history of an operated primary spinal melanoma from T7-T9, which had remained stable for these 17 years. Routine laboratory findings and clinical symptoms aroused suspicion of a metastatic disease. Multislice computed tomography and magnetic resonance imaging revealed stage-IV melanoma with thoracic, abdominal and skeletal metastases without the recurrence of the primary process. Transiliac crest core bone biopsy confirmed the diagnosis of metastatic melanoma. It is important to know that in all cases of back ore skeletal pain and unexplained weight loss, malignancy must always be considered in the differential diagnosis, especially in the subjects with a positive medical history. Patients who have back, skeletal, or joint pain that is unresponsive to a few weeks of conservative treatment or have known risk factors with or without serious etiology, are candidates for imaging studies. The present case demonstrates that complete surgical resection alone may result in a favourable outcome, but regular medical follow-up for an extended period, with the purpose of an early detection of a metastatic disease, is highly recommended.

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

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.

Findings from CT, MRI, and PET/CT of a primary malignant melanoma arising in a spinal nerve root

Primary spinal malignant melanoma is an extremely rare condition. We here describe a case of a 71-year-old Asian female presenting with left upper extremity tingling sensation. Computed tomography (CT) showed a homogeneously enhanced mass occupying the left neural foramen at the C6-7 level. Magnetic resonance imaging revealed enhanced mass in intra- and extradural space compressing the spinal cord at this level. It also widened the neural foramen mimicking neurofibroma or schwannoma. Partial resection of the mass was performed. Pathologic diagnosis of the mass was malignant melanoma. Postoperative whole body positron emission tomography/CT scan demonstrated an intense (18)F-FDG uptake at the residual mass site without abnormal uptake at other sites in the body.

Primary spinal melanoma of the cervical leptomeninges: Report of a case with brief review of literature

Central nervous system primary malignant melanoma accounts for approximately 1% of all melanomas. Primary spinal melanomas are even more unusual. We report a patient with primary spinal melanoma of the cervical leptomeninges. The histology of the tumor showed tumor cells arranged in sheets, ill-defined fascicles and nests and displayed a moderate grade of cellular and nuclear pleomorphism and mitoses with abundant pigment in the cytoplasm. The tumor cells were immunoreactive for HMB-45, and for S-100.

Intramedullary Primary Cervical Melanoma

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.

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

A 49-year-old man was admitted suffering from headache persisting for a month. He had a history of primary spinal intramedullary malignant melanoma at the T6 level 18 years previously, which had remained stable for 18 years. Magnetic resonance imaging revealed central nervous system (CNS) dissemination of malignant melanoma. Whole brain radiation therapy (30 Gy), local radiation therapy (15 Gy), and routine intrathecal injection of interferon beta were performed. The progression of CNS dissemination of malignant melanoma was controlled without neurological deterioration for 38 months. The prognosis for primary CNS malignant melanomas better than that for cutaneous melanoma. However, the clinical course is still unknown, and CNS dissemination is regarded fatal. The unusually long survival in the present case indicates the effectiveness of the combined radiotherapy and interferon therapy.

Primary spinal melanoma: presentation of a casewith prolonged course

Primary spinal melanoma: presentation of a casewith prolonged course

Primary intramedullary melanoma

Primary intramedullary melanoma is a very rare tumor, most frequently occurring in the middle or lower thoracic spinal cord. The authors present a new case of primary cervical cord melanoma that developed in a 62-year-old man whose tumor was surgically treated and subsequently received radiation therapy. Clinical and histogenetic features of this neoplasm, results of chemo-, radio-, and immunotherapy are reported. Both “disembryogenetic” and “mesodermal” hypotheses on the origin of primary spinal melanoma are discussed.

Primary spinal melanoma: case report

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.