Primary Spinal Malignant Melanoma Mimicking a Cervical Nerve Root Schwannoma: Case Report and Literature Review
Primary spinal malignant melanoma (PSMM) is a rare cancer of the central nervous system (CNS), and PSMM of the spinal nerve root is even more extraordinary. PSMM of a nerve root can mimic the radiographic appearance of benign nerve sheath tumors, thus resulting in misdiagnosis until tissue diagnosis...
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| Published in | Asian journal of neurosurgery Vol. 19; no. 3; pp. 540 - 550 |
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| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
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India
Thieme Medical and Scientific Publishers Pvt. Ltd
01.09.2024
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| Online Access | Get full text |
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| Abstract | Primary spinal malignant melanoma (PSMM) is a rare cancer of the central nervous system (CNS), and PSMM of the spinal nerve root is even more extraordinary. PSMM of a nerve root can mimic the radiographic appearance of benign nerve sheath tumors, thus resulting in misdiagnosis until tissue diagnosis can be made. A 53-year-old African American woman presented with pain primarily involving the left aspect of her neck and shoulder for 2 years. Magnetic resonance imaging (MRI) of the cervical spine demonstrated a T1-hyperintense, T2-hypointense, homogenously enhancing, dumbbell-shaped, intradural extramedullary mass extending out through the left C2-3 foramen. A midline incision was used to perform a C2 and C3 laminectomy, and the mass was removed from the cavity. The histopathologic profile was consistent with the diagnosis of malignant melanoma. The present case report adds to the 110 cases of PSMM and the 20 cases of PSMM of the spinal nerve root in the existing body of literature. Radiographic and clinical features resemble that of the much more common schwannoma or neurofibroma requiring immunohistochemical analysis for definitive diagnosis. The optimal treatment for PSMM has not yet been defined due to its rarity and it is therefore important to report such cases in order to share our clinical experiences and provide data to other clinicians treating this uncommon disease. |
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| AbstractList | Abstract Primary spinal malignant melanoma (PSMM) is a rare cancer of the central nervous system (CNS), and PSMM of the spinal nerve root is even more extraordinary. PSMM of a nerve root can mimic the radiographic appearance of benign nerve sheath tumors, thus resulting in misdiagnosis until tissue diagnosis can be made. A 53-year-old African American woman presented with pain primarily involving the left aspect of her neck and shoulder for 2 years. Magnetic resonance imaging (MRI) of the cervical spine demonstrated a T1-hyperintense, T2-hypointense, homogenously enhancing, dumbbell-shaped, intradural extramedullary mass extending out through the left C2–3 foramen. A midline incision was used to perform a C2 and C3 laminectomy, and the mass was removed from the cavity. The histopathologic profile was consistent with the diagnosis of malignant melanoma. The present case report adds to the 110 cases of PSMM and the 20 cases of PSMM of the spinal nerve root in the existing body of literature. Radiographic and clinical features resemble that of the much more common schwannoma or neurofibroma requiring immunohistochemical analysis for definitive diagnosis. The optimal treatment for PSMM has not yet been defined due to its rarity and it is therefore important to report such cases in order to share our clinical experiences and provide data to other clinicians treating this uncommon disease. Primary spinal malignant melanoma (PSMM) is a rare cancer of the central nervous system (CNS), and PSMM of the spinal nerve root is even more extraordinary. PSMM of a nerve root can mimic the radiographic appearance of benign nerve sheath tumors, thus resulting in misdiagnosis until tissue diagnosis can be made. A 53-year-old African American woman presented with pain primarily involving the left aspect of her neck and shoulder for 2 years. Magnetic resonance imaging (MRI) of the cervical spine demonstrated a T1-hyperintense, T2-hypointense, homogenously enhancing, dumbbell-shaped, intradural extramedullary mass extending out through the left C2-3 foramen. A midline incision was used to perform a C2 and C3 laminectomy, and the mass was removed from the cavity. The histopathologic profile was consistent with the diagnosis of malignant melanoma. The present case report adds to the 110 cases of PSMM and the 20 cases of PSMM of the spinal nerve root in the existing body of literature. Radiographic and clinical features resemble that of the much more common schwannoma or neurofibroma requiring immunohistochemical analysis for definitive diagnosis. The optimal treatment for PSMM has not yet been defined due to its rarity and it is therefore important to report such cases in order to share our clinical experiences and provide data to other clinicians treating this uncommon disease.Primary spinal malignant melanoma (PSMM) is a rare cancer of the central nervous system (CNS), and PSMM of the spinal nerve root is even more extraordinary. PSMM of a nerve root can mimic the radiographic appearance of benign nerve sheath tumors, thus resulting in misdiagnosis until tissue diagnosis can be made. A 53-year-old African American woman presented with pain primarily involving the left aspect of her neck and shoulder for 2 years. Magnetic resonance imaging (MRI) of the cervical spine demonstrated a T1-hyperintense, T2-hypointense, homogenously enhancing, dumbbell-shaped, intradural extramedullary mass extending out through the left C2-3 foramen. A midline incision was used to perform a C2 and C3 laminectomy, and the mass was removed from the cavity. The histopathologic profile was consistent with the diagnosis of malignant melanoma. The present case report adds to the 110 cases of PSMM and the 20 cases of PSMM of the spinal nerve root in the existing body of literature. Radiographic and clinical features resemble that of the much more common schwannoma or neurofibroma requiring immunohistochemical analysis for definitive diagnosis. The optimal treatment for PSMM has not yet been defined due to its rarity and it is therefore important to report such cases in order to share our clinical experiences and provide data to other clinicians treating this uncommon disease. Primary spinal malignant melanoma (PSMM) is a rare cancer of the central nervous system (CNS), and PSMM of the spinal nerve root is even more extraordinary. PSMM of a nerve root can mimic the radiographic appearance of benign nerve sheath tumors, thus resulting in misdiagnosis until tissue diagnosis can be made. A 53-year-old African American woman presented with pain primarily involving the left aspect of her neck and shoulder for 2 years. Magnetic resonance imaging (MRI) of the cervical spine demonstrated a T1-hyperintense, T2-hypointense, homogenously enhancing, dumbbell-shaped, intradural extramedullary mass extending out through the left C2-3 foramen. A midline incision was used to perform a C2 and C3 laminectomy, and the mass was removed from the cavity. The histopathologic profile was consistent with the diagnosis of malignant melanoma. The present case report adds to the 110 cases of PSMM and the 20 cases of PSMM of the spinal nerve root in the existing body of literature. Radiographic and clinical features resemble that of the much more common schwannoma or neurofibroma requiring immunohistochemical analysis for definitive diagnosis. The optimal treatment for PSMM has not yet been defined due to its rarity and it is therefore important to report such cases in order to share our clinical experiences and provide data to other clinicians treating this uncommon disease. |
| Author | Gold, Justin Patel, Nitesh Weiner, Joseph Hernandez, Nick R Wong, Timothy Hanft, Simon |
| AuthorAffiliation | 4 Department of Neurological Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York, United States 3 Department of Radiation Oncology, Robert Wood Johnson Hospital, New Brunswick, New Jersey, United States 2 Department of Neurosurgery, Robert Wood Johnson Hospital, New Brunswick, New Jersey, United States 1 Department of Neurological Surgery, Cooper Medical of Rowan University, Camden, New Jersey, United States |
| AuthorAffiliation_xml | – name: 4 Department of Neurological Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York, United States – name: 3 Department of Radiation Oncology, Robert Wood Johnson Hospital, New Brunswick, New Jersey, United States – name: 2 Department of Neurosurgery, Robert Wood Johnson Hospital, New Brunswick, New Jersey, United States – name: 1 Department of Neurological Surgery, Cooper Medical of Rowan University, Camden, New Jersey, United States |
| Author_xml | – sequence: 1 givenname: Justin surname: Gold fullname: Gold, Justin organization: Department of Neurological Surgery, Cooper Medical of Rowan University, Camden, New Jersey, United States – sequence: 2 givenname: Nick R surname: Hernandez fullname: Hernandez, Nick R organization: Department of Neurosurgery, Robert Wood Johnson Hospital, New Brunswick, New Jersey, United States – sequence: 3 givenname: Timothy surname: Wong fullname: Wong, Timothy organization: Department of Neurosurgery, Robert Wood Johnson Hospital, New Brunswick, New Jersey, United States – sequence: 4 givenname: Nitesh surname: Patel fullname: Patel, Nitesh organization: Department of Neurosurgery, Robert Wood Johnson Hospital, New Brunswick, New Jersey, United States – sequence: 5 givenname: Joseph surname: Weiner fullname: Weiner, Joseph organization: Department of Radiation Oncology, Robert Wood Johnson Hospital, New Brunswick, New Jersey, United States – sequence: 6 givenname: Simon surname: Hanft fullname: Hanft, Simon organization: Department of Neurological Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York, United States |
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| Cites_doi | 10.1186/1477-7819-9-150 10.1080/02688690701242235 10.1080/02688699845384 10.1055/s-0039-1697559 10.3892/ol.2014.2099 10.1227/00006123-199403000-00023 10.3171/jns.1987.66.1.0047 10.1007/s00586-010-1285-1 10.3349/ymj.2004.45.2.345 10.1136/jnnp.39.6.526 10.3171/jns.1960.17.6.0935 10.1097/00000478-199907000-00001 10.3322/canjclin.56.2.106 10.3171/jns.1961.18.5.0616 10.3340/jkns.2010.48.2.157 10.1038/scsandc.2015.3 10.1016/S0190-9622(96)90041-9 10.3171/jns.1998.89.4.0659 10.1016/j.ejca.2018.12.023 10.1002/cncr.25634 10.2106/00004623-196850040-00009 10.1200/JCO.2004.09.021 10.1007/s11060-017-2593-7 10.4103/0028-3886.82758 10.1111/j.1365-2559.2003.01679.x 10.1215/15228517-2007-058 10.3171/2017.1.JNS162797 10.1177/147323001204000341 10.1016/j.wneu.2017.12.117 10.1007/BF01944932 10.1016/j.jocn.2019.12.063 10.3171/jns.1987.67.6.0923 10.1016/j.clineuro.2011.09.012 10.1007/s11060-018-03071-1 |
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| Copyright | Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ). Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( ) 2024 Asian Congress of Neurological Surgeons. |
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| Keywords | spine surgery case report malignant melanoma nerve root schwannoma |
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| References | O Ganiüsmen (ref22) 2012; 114 T C Larson III (ref33) 1987; 66 P François (ref4) 1998; 12 A N Kanatas (ref19) 2007; 21 R D Hayward (ref32) 1976; 39 Y P Li (ref9) 2014; 8 L Wu (ref34) 2017; 135 F A McHugh (ref40) 2020; 73 A Sharma (ref27) 2019; 10 M S Kim (ref7) 2010; 48 Q Y Liu (ref10) 2015; 1 F M Salpietro (ref6) 1998; 89 B I Roh (ref20) 2009; 6 L Yan (ref23) 2012; 125 H Beculic (ref26) 2015; 30 D Farrokh (ref30) 2001; 22 C Zou (ref11) 2018; 111 N K Lee (ref31) 2010; 19 D J Brat (ref36) 1999; 23 R Rauschenberg (ref41) 2019; 110 A Sanz-Trelles (ref15) 2003; 43 A Naing (ref18) 2004; 22 I C Glitza (ref3) 2016 A Hirano (ref5) 1960; 17 J J Raizer (ref38) 2008; 10 J Yu (ref8) 2012; 40 R Kotecha (ref39) 2018; 129 D S Rigel (ref1) 1996; 34 S C Kwon (ref16) 2004; 45 Z Zhang (ref35) 2019; 142 R Sinha (ref24) 2013; 7 A Hirschberg (ref28) 1906; 186 S O Skarli (ref14) 1994; 34 S Jaiswal (ref25) 2011; 59 D Katalinic (ref21) 2011; 9 M A Davies (ref37) 2011; 117 A Montinaro (ref17) 2004; 48 A Jemal (ref2) 2006; 56 S J Schneider (ref13) 1987; 67 W J Holaday (ref12) 1968; 50 F WSL Kiel (ref29) 1961; 18 |
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| Snippet | Primary spinal malignant melanoma (PSMM) is a rare cancer of the central nervous system (CNS), and PSMM of the spinal nerve root is even more extraordinary.... Abstract Primary spinal malignant melanoma (PSMM) is a rare cancer of the central nervous system (CNS), and PSMM of the spinal nerve root is even more... |
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| Title | Primary Spinal Malignant Melanoma Mimicking a Cervical Nerve Root Schwannoma: Case Report and Literature Review |
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