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Kamabu LK, Kataka LM, Vivalya BMN, Sikakulya FK, Lekuya HM, Galukande M. Primary malignant melanoma, an atypical presentation in the cervical spine: a case report. J Med Case Rep 2023; 17:548. [PMID: 38104134 PMCID: PMC10725590 DOI: 10.1186/s13256-023-04290-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 11/21/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Few studies have documented the occurrence of melanoma in the cervical spine. Of all malignant melanoma cases, 1% are primary melanoma of the central nervous system, which makes it extremely uncommon and nonspecific. We aim to report a case of the uncommon presentation of primary melanoma in the cervical spine. CASE PRESENTATION The patient was a 59-year-old Muganda male who presented with a 2-year history of anterior neck swelling as well as severe pain and a tingling sensation in the left shoulder and arm, which worsened in the recent 6 months. He developed weakness and paresthesia in the upper left arm and progressive gait disturbance of the left leg. A physical examination revealed masses in the left cervical and right submandibular region. Additionally, the upper and lower left extremities revealed hemiparesis and hemihypoesthesia. A magnetic resonance imaging scan showed a hyperintense lesion on TIWI and another hypointense lesion on T2WI, originating from the cervical spine and involving the vertebral bodies and paravertebral soft tissues. The patient underwent surgery, a black tumor was extracted, and histology revealed the tumor to be malignant melanoma. The patient died within 1 month after the diagnosis and surgery. CONCLUSION This case is presented to highlight the significance and challenges associated with making a pre- and postoperative diagnosis of primary cervical melanoma with atypical radiological characteristics. Patients with extradural lesions that show hyperintensity on T1-weighted images and hypointensity on T2-weighted images should have spinal melanoma examined as a possible differential diagnosis.
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Affiliation(s)
- Larrey Kasereka Kamabu
- Department of Surgery, Neurosurgery, College of Medicine, Makerere University, Kampala, Uganda.
- Faculty of Medicine, Université Catholique du Graben, Butembo, Democratic Republic of the Congo.
| | - Louange Maha Kataka
- Faculty of Medicine, Université Catholique du Graben, Butembo, Democratic Republic of the Congo
| | - Bives Mutume Nzanzu Vivalya
- Department of Internal Medicine, Masereka General Hospital, Goma, North-Kivu, Democratic Republic of the Congo
- Department of Psychiatry and Mental Health, Kampala International University Western Campus, Ishaka, Uganda
| | - Franck Katembo Sikakulya
- Faculty of Medicine, Université Catholique du Graben, Butembo, Democratic Republic of the Congo
- Department of Surgery, Kampala International University, Western Campus, Ishaka, Uganda
| | - Hervé Monka Lekuya
- Department of Surgery, Neurosurgery, College of Medicine, Makerere University, Kampala, Uganda
- Directorate of Surgical Services, Neurosurgical Unit, Mulago National Referral Hospital, Kampala, Uganda
| | - Moses Galukande
- Department of Surgery, Neurosurgery, College of Medicine, Makerere University, Kampala, Uganda
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Shi YF, Chen YQ, Chen HF, Hu X. An atypical primary malignant melanoma arising from the cervical nerve root: A case report and review of literture. World J Clin Cases 2022; 10:381-387. [PMID: 35071542 PMCID: PMC8727269 DOI: 10.12998/wjcc.v10.i1.381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 10/29/2021] [Accepted: 11/30/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Primary melanomas affecting the central nervous system are very rare, and melanomas originating in the spinal canal or origin of the spinal nerve root are even rarer. As a consequence, not much is known about this.
CASE SUMMARY Here we report a case of primary malignant melanoma originating in the cervical spinal cord nerve root. A 64-year-old woman presented with symptoms of numbness in the right side of the neck, pain, and hypoesthesia in the right upper limb which persisted for 1 year. Neurological examination showed that the superficial sensation in the right upper limb had decreased with muscle strength of grade 4. Magnetic resonance imaging examination revealed a mass (approximately 2.5 cm × 1.4 cm × 1 cm) in the right side of the spinal canal in the C-2 plane. Based on findings obtained during operation, perioperative examination, pathological diagnosis, and the diagnostic criteria of primary central melanoma proposed by Hayward, the mass was confirmed to be a melanoma of intraspinal nerve root origin.
CONCLUSION This is the first case of primary malignant melanoma originating from cervical spinal cord nerve roots and spread along the inside and outside of the spinal canal. The clinical relevance of this case is discussed to provide new insights into the differential diagnosis of intraspinal tumours. Further studies are needed to better understand the mechanisms driving the growth pattern and development of this type of tumour.
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Affiliation(s)
- Yi-Feng Shi
- Department of Neurosurgery, West China Hospital, Chengdu 610041, Sichuan Province, China
| | - Yu-Qi Chen
- Department of Neurosurgery, West China Hospital, Chengdu 610041, Sichuan Province, China
| | - Hai-Feng Chen
- Department of Neurosurgery, West China Hospital, Chengdu 610041, Sichuan Province, China
| | - Xin Hu
- Department of Neurosurgery, West China Hospital, Chengdu 610041, Sichuan Province, China
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Manan A, Rizvi S, Kondlapudi J. Intramedullary Spinal Cord Metastasis as Initial Presentation of Malignant Melanoma: A Unique Case Report and Role of Contrast vs Non-contrast MRI in Its Diagnosis. Cureus 2021; 13:e19731. [PMID: 34934593 PMCID: PMC8684581 DOI: 10.7759/cureus.19731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2021] [Indexed: 11/16/2022] Open
Abstract
Intramedullary spinal cord metastasis (ISCM) is a diagnostically challenging and dreadful complication of cancer. Twenty-seven cases of ISCM exclusively related to malignant melanoma have been reported so far in a recent study.On review of literature, we could not find any reported case with ISCM secondary to malignant melanoma as initial presentation. To the best of our knowledge, we are reporting the first such case. We report a case of a 71-year-old lady presenting with gradual onset of bilateral leg weakness “off legs” and lower limb paresthesias. On examination she had an upper motor neuron pattern lower limb weakness with reduced sensations to all modalities and brisk reflexes with extensor plantar responses. She was evaluated with non-contrast MRI (magnetic resonance imaging) spine which showed focal myelopathic cord signal at the conus and at the level of T10 and T11 vertebrae (radiological differential diagnosis given on MRI were B12 deficiency/inflammatory/infection). Thorough radiological scans were ordered which revealed a disseminated malignancy. A biopsy sample from gastric lesion revealed diagnosis of malignant melanoma. A repeat MRI whole spine with gadolinium contrast was done later with suspicion of spinal metastasis which has led to lower limb weakness. MRI with contrast showed an enhancing soft tissue metastatic mass lesion within conus in comparison with plain MRI done one week earlier. At present, diagnostic modalities available for diagnosing ISCM particularly secondary to melanoma do not have high specificity. Contrast MRI is the diagnostic modality of choice at present. Non-contrast MRI has low sensitivity in diagnosis of ISCM compared to contrast MRI and could potentially delay the management, especially in highly aggressive malignancies like malignant melanoma where an early diagnosis and treatment is critical for better outcome.
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Affiliation(s)
- Abdul Manan
- Nephrology and General Internal Medicine, The Royal Wolverhampton NHS Trust, Wolverhampton, GBR
| | - Syed Rizvi
- Acute and General Internal Medicine, University Hospitals Birmingham, Birmingham, GBR
| | - Jyothi Kondlapudi
- Nephrology and General Internal Medicine, The Royal Wolverhampton NHS Trust, Wolverhampton, GBR
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Haberfellner E, Elbaroody M, Alkhamees AF, Alaosta A, Eaton S, Quint E, Shahab S, O'Connor A, Im J, Khan A, El-Gohary Y, Lotfy M, Sawan M, Shamisa A, Soliman MAR. Primary Spinal Melanoma: Case Report and Systematic Review. Clin Neurol Neurosurg 2021; 205:106649. [PMID: 33932774 DOI: 10.1016/j.clineuro.2021.106649] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/15/2021] [Accepted: 04/10/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Primary malignant melanoma of the spinal cord (PSM) is a rare condition with limited evidence regarding its diagnosis (clinical and radiographic), management, and prognosis. Our aim was to report an extremely rare two cases of primary malignant melanoma of the spine one of them is sacral melanoma which represents the second reported case in the literature and to conduct a systematic review of the relevant literature. METHODS The diagnosis and management of these cases were retrospectively reviewed. Using the PRISMA guideline, we conducted a systematic review of the literature to analyze different management strategies and the prognosis of such pathology. RESULTS All two patients were operated on, and received gross total removal of their tumors, with extended follow up for tumor recurrences. One of the cases involved a sacral tumor, which was resected without adjuvant therapy. The other one was seen by oncology and received post-operative chemo- and radio- therapy. In addition to the aforementioned cases, we present a comprehensive review of the literature on PSM from 1950 to the present, demonstrating that PSM is a very rare tumor, with a limited counted number of cases reported worldwide. CONCLUSION In conclusion, we report an exceedingly rare two cases of primary malignant melanoma of the spine. Early surgical intervention is key to the management of these rare and aggressive tumors. GTR should be attempted if possible.
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Affiliation(s)
- Erika Haberfellner
- Schulich School of Medicine and Dentistry, Western University, Ontario, Canada
| | | | - Abdullah F Alkhamees
- Schulich School of Medicine and Dentistry, Western University, Ontario, Canada; Neurosurgery Department, Qassim University, Kingdom of Saudi Arabia
| | - Abdelfatah Alaosta
- Schulich School of Medicine and Dentistry, Western University, Ontario, Canada; Neurosurgery Department, Sirte University, Libya
| | - Sydney Eaton
- Schulich School of Medicine and Dentistry, Western University, Ontario, Canada
| | - Elise Quint
- Schulich School of Medicine and Dentistry, Western University, Ontario, Canada
| | - Saba Shahab
- Schulich School of Medicine and Dentistry, Western University, Ontario, Canada
| | - Avalon O'Connor
- Schulich School of Medicine and Dentistry, Western University, Ontario, Canada
| | - Jacob Im
- Schulich School of Medicine and Dentistry, Western University, Ontario, Canada
| | - Asham Khan
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, United States
| | - Yasser El-Gohary
- Pathology Department, Windsor Regional Hospital, Western University, Canada
| | | | | | - Abdalla Shamisa
- Neurosurgery Department, Windsor Regional Hospital, Western University, Canada
| | - Mohamed A R Soliman
- Schulich School of Medicine and Dentistry, Western University, Ontario, Canada; Neurosurgery Department, Cairo University, Egypt.
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Corrêa DG, dos Santos RQ, Hygino da Cruz LC. Primary intramedullary malignant melanoma: can imaging lead to the correct diagnosis? J Int Med Res 2020; 48:300060520966152. [PMID: 33103574 PMCID: PMC7645401 DOI: 10.1177/0300060520966152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 09/23/2020] [Indexed: 12/17/2022] Open
Abstract
Melanoma is a malignant neoplasm of melanin-producing cells. Melanoma usually occurs in the skin, but can also arise in any anatomical site that contains melanocytes, such as mucous membranes, the eyes, and the central nervous system (CNS). Primary CNS malignant melanoma most often develops in the leptomeninges. We report a case of a rare intramedullary melanoma of the thoracic spinal cord. A 78-year-old man was treated with surgery, radiotherapy, and immunotherapy for leptomeningeal spread. We also discuss the role of imaging methods in diagnosis and follow-up. Medullary melanoma occurs more frequently in adults. The most common presenting symptoms are the insidious onset of lower extremity weakness and paresthesia. Magnetic resonance imaging is the method of choice for evaluation. Although there are no imaging features to accurately distinguish primary malignant melanoma from other melanocytic or hemorrhagic tumors, hyperintensity on T1-weighted magnetic resonance imaging should lead to inclusion of this neoplasm in differential diagnosis of spinal cord tumors. Positron emission tomography-computed tomography is a useful auxiliary examination to evaluate the extent of local and metastatic disease. Surgical resection is the primary treatment for intramedullary melanoma. However, the efficacy of adjunctive radiotherapy and chemotherapy for primary spinal cord malignant melanoma is still controversial.
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Affiliation(s)
- Diogo Goulart Corrêa
- Clínica de Diagnóstico por Imagem (CDPI)/DASA, Avenida das Américas, 4666, 302A, 303, 307, 325, 326, Barra da Tijuca, Rio de Janeiro, RJ, Brazil
- Hospital Universitário Antônio Pedro, Federal Fluminense University, Avenida Marquês do Paraná, 303, Centro, Niterói, RJ, Brazil
| | - Roberto Queiroz dos Santos
- Hospital dos Servidores do Estado, Rua Sacadura Cabral, 178, Saúde, Rio de Janeiro, RJ, Brazil
- Americas Medical City Hospital, Avenida Jorge Curi, 550, Barra da Tijuca, Rio de Janeiro, RJ, Brazil
| | - Luiz Celso Hygino da Cruz
- Clínica de Diagnóstico por Imagem (CDPI)/DASA, Avenida das Américas, 4666, 302A, 303, 307, 325, 326, Barra da Tijuca, Rio de Janeiro, RJ, Brazil
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Zhang M, Liu R, Xiang Y, Mao J, Li G, Ma R, Sun Z. Primary Spinal Cord Melanoma: A Case Report and a Systemic Review of Overall Survival. World Neurosurg 2018; 114:408-420. [PMID: 29614357 DOI: 10.1016/j.wneu.2018.03.169] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 03/22/2018] [Accepted: 03/23/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND The incidence of primary spinal cord melanoma (PSCM) is rare. Several case series and case reports have been published in the literature. However, the predictive factors of PSCM survival and management options are not discussed in detail. METHODS We present a case of PSCM; total resection was achieved and chemotherapy was given postoperatively. A comprehensive search was performed on PubMed's electronic database using the words "primary spinal cord melanoma." Survival rates with various gender, location, treatment, and metastasis condition were collected from the published articles and analyzed. RESULTS Fifty nine cases were eligible for the survival analysis; 54% were male and 46% were female. Patient sex did not influence overall survival. The most common location was the thorax. Patient sex and tumor location did not influence overall survival. The major presenting symptoms were weakness and paresthesia of the extremities. Metastasis or dissemination was noted in 45.16% of 31 patients. In the Kaplan-Meier survival analysis, patients who had metastasis had the worst prognosis. Extent of resection was not related to mortality. Patients who received surgery and surgery with adjuvant therapy had a better median survival than did those who had adjuvant therapy alone. Prognosis was worst in those patients who underwent only adjuvant therapy without surgery (5 months). CONCLUSIONS Surgery is the first treatment of choice in treating PSCM. The goal of tumor resection is to reduce symptoms. Adjuvant therapy after surgery had a beneficial effect on limiting the metastasis.
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Affiliation(s)
- Mingzhe Zhang
- Department of Neurosurgery, Harrison International Peace Hospital, Hebei Medical University, Hebei, China
| | - Raynald Liu
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Yi Xiang
- Department of Neurosurgery, Harrison International Peace Hospital, Hebei Medical University, Hebei, China
| | - Jianhui Mao
- Department of Neurosurgery, Harrison International Peace Hospital, Hebei Medical University, Hebei, China
| | - Guangjie Li
- Department of Neurosurgery, Harrison International Peace Hospital, Hebei Medical University, Hebei, China
| | - Ronghua Ma
- Department of Neurosurgery, Harrison International Peace Hospital, Hebei Medical University, Hebei, China
| | - Zhaosheng Sun
- Department of Neurosurgery, Harrison International Peace Hospital, Hebei Medical University, Hebei, China.
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Liu QY, Liu AM, Li HG, Guan YB. Primary spinal melanoma of extramedullary origin: a report of three cases and systematic review of the literature. Spinal Cord Ser Cases 2015; 1:15003. [PMID: 28053708 DOI: 10.1038/scsandc.2015.3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 01/12/2015] [Accepted: 01/14/2015] [Indexed: 02/06/2023] Open
Abstract
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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Affiliation(s)
- Q-Y Liu
- Department of Radiology, Zengcheng People's Hospital, Zengcheng, Guangdong Province, China; Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - A-M Liu
- Division of Neurosurgery, Department of Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University , Guangzhou, Guangdong Province, China
| | - H-G Li
- Department of Pathology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University , Guangzhou, Guangdong Province, China
| | - Y-B Guan
- Department of Radiology, First Affiliated Hospital of Guangzhou Medical University , Guangzhou City, Guangdong Province, China
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LI YUPING, ZHANG HENGZHU, SHE LEI, WANG XIAODONG, DONG LUN, XU ENXI, WANG XINGDONG. Primary extramedullary spinal melanoma mimicking spinal meningioma: A case report and literature review. Oncol Lett 2014; 8:339-344. [PMID: 24959273 PMCID: PMC4063659 DOI: 10.3892/ol.2014.2099] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 04/10/2014] [Indexed: 01/05/2023] Open
Abstract
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.
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Affiliation(s)
- YU-PING LI
- Department of Neurosurgery, Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu 225001, P.R. China
| | - HENG-ZHU ZHANG
- Department of Neurosurgery, Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu 225001, P.R. China
| | - LEI SHE
- Department of Neurosurgery, Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu 225001, P.R. China
| | - XIAO-DONG WANG
- Department of Neurosurgery, Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu 225001, P.R. China
| | - LUN DONG
- Department of Neurosurgery, Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu 225001, P.R. China
| | - ENXI XU
- Department of Neurosurgery, Zhenjiang First People’s Hospital, Zhenjiang, Jiangsu 212002, P.R. China
| | - XING-DONG WANG
- Department of Neurosurgery, Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu 225001, P.R. China
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Sun L, Song Y, Gong Q. Easily misdiagnosed delayed metastatic intraspinal extradural melanoma of the lumbar spine: A case report and review of the literature. Oncol Lett 2013; 5:1799-1802. [PMID: 23833644 PMCID: PMC3700799 DOI: 10.3892/ol.2013.1299] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Accepted: 03/14/2013] [Indexed: 02/06/2023] Open
Abstract
Metastatic melanoma of the spine usually occurs as vertebral metastatic melanoma or intramedullary spinal cord metastatic melanoma. The present study reports a case of easily misdiagnosed delayed metastatic intraspinal extradural melanoma of the lumbar spine. A 67-year-old female patient presented with lower back pain accompanied by progressive intermittent claudication. Magnetic resonance imaging (MRI) suggested compression of the lumbar spinal cord caused by an extradural mass. The mass showed T2-hypointensity, T1-hypointensity and slight enhancement following a gadolinium-contrast injection. The patient had been diagnosed with a vulvar melanoma 13 years previously and had also undergone a resection of this tumor. A current diagnosis of a lumbar stenosis resulting from hypertrophy of the ligamentum flavum was suspected. However during corrective surgery, a dark gray solid mass was observed. An L3 laminectomy and removal of the tumor was performed. The tumor was confirmed to be a malignant melanoma by histopathological investigation. The patient was treated with radiotherapy and immunotherapy. At the final 13-month follow-up, the patient showed no signs of recurrence. It may be concluded that an early diagnosis of metastatic melanoma was prevented by delayed metastasis, the location of the mass and its unusual appearance in MRI scans. In such cases, early surgical removal and an appropriate comprehensive treatment are critical for patient survival. These observations suggest that caution should be used in the diagnosis of similar cases.
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Affiliation(s)
- Lin Sun
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
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Yu J, Zhao DD, Chen S, Zhang JM, Xu J. Primary melanoma of the cervical spine with cerebral metastases: case report and review of the literature. J Int Med Res 2013; 40:1207-15. [PMID: 22906295 DOI: 10.1177/147323001204000341] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
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.
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Affiliation(s)
- J Yu
- Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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