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. 2015 Jul 9:1:15003.
doi: 10.1038/scsandc.2015.3. eCollection 2015.

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

Q-Y Liu  1 , A-M Liu  2 , H-G Li  3 , Y-B Guan  4
Affiliations

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

Q-Y Liu et al. Spinal Cord Ser Cases. .

Erratum in

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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Figures

Figure 1
Figure 1
A 39-year-old male with PSM of extramedullary origin at T9-10. MRI shows a hyperintense mass (arrow) on sagittal T1W image (a), hypointense on sagittal T2W image (b) at T9-10 (arrow) and homogeneous enhancement after contrast administration on axial image (c).
Figure 2
Figure 2
A 47-year-old male with PSM of extramedullary origin at C4-5. MRI shows a hyperintense mass on sagittal T1W image (a), hypointense on sagittal T2W image at C4-5 (b) and homogeneously mild enhancement after contrast administration on axial image, which extends to the right intervertebral foramen (c).
Figure 3
Figure 3
A 76-year-old male with PSM of extramedullary origin at L2-3. MRI shows a slightly hyperintense mass on sagittal T1W image (a) and hypointense on sagittal T2W image (b). Hematoxylin and eosin staining shows a highly cellular malignant tumor with dense deposition of melanin granules (200×) (c) and immunohistochemical studies showed positivity for HMB-45 (200×) (d).
See this image and copyright information in PMC

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