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Primary Intradural Extramedullary Spinal Melanoma in the Lower Thoracic Spine.

Hering K, Bresch A, Lobsien D, Mueller W, Kortmann RD, Seidel C - Case Rep Oncol Med (2016)

Bottom Line: Purpose.Results.Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiotherapy and Radiation Oncology, Leipzig University, Liebigstrasse 20, 04103 Leipzig, Germany.

ABSTRACT

Unlabelled: Background Context. Up to date, only four cases of primary intradural extramedullary spinal cord melanoma (PIEM) have been reported. No previous reports have described a case of PIEM located in the lower thoracic spine with long-term follow-up. Purpose. Demonstrating an unusual, extremely rare case of melanoma manifestation. Study Design.

Case report: Methods. We report a case of a 57-year-old female suffering from increasing lower extremity pain, left-sided paresis, and paraesthesia due to spinal cord compression caused by PIEM in the lower thoracic spine. Results. Extensive investigation excluded other possible primary melanoma sites and metastases. For spinal cord decompression, the tumor at level T12 was resected, yet incompletely. Adjuvant radiotherapy was administered two weeks after surgery. The patient was recurrence-free at 104 weeks after radiotherapy but presents with unchanged neurological symptoms. Conclusion. Primary intradural extramedullary melanoma (PIEM) is extremely rare and its clinical course is unpredictable.

No MeSH data available.


Related in: MedlinePlus

Preoperative sagittal MRI shows the spinal cord tumor at the level of the conus medullaris (arrow). T1-weighted MRI with gadolinium shows high signal intensity relative to that of the cord (a) and T2-weighted MRI shows inhomogenous hypointensive signal (b). Four weeks' follow-up sagittal T1-weighted MRI with gadolinium (c) and T2-weighted MRI (d) and 28 weeks' follow-up T1-weighted MRI with gadolinium (e) and T2-weighted MRI (f) show the residual tumor (arrow).
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fig1: Preoperative sagittal MRI shows the spinal cord tumor at the level of the conus medullaris (arrow). T1-weighted MRI with gadolinium shows high signal intensity relative to that of the cord (a) and T2-weighted MRI shows inhomogenous hypointensive signal (b). Four weeks' follow-up sagittal T1-weighted MRI with gadolinium (c) and T2-weighted MRI (d) and 28 weeks' follow-up T1-weighted MRI with gadolinium (e) and T2-weighted MRI (f) show the residual tumor (arrow).

Mentions: A 57-year-old female patient was admitted for generalized pain in the lower extremities with mild left-sided distal paresis of the left leg and paraesthesia of the left lower leg and foot progressing for 2 months. Spinal magnetic resonance imaging (MRI) showed an intraspinal mass in the region of the lower thoracic spine at the level of the T12 vertebrae. It was hyperintense on gadolinium enhanced T1-weighted images (Figure 1(a)) and inhomogenous and hypointensive on T2-weighted images (Figure 1(b)). A subsequent MRI scan of the brain and entire spine revealed no other suspect lesions. Due to increasing pain, rapid resection was planned for suspected tumor.


Primary Intradural Extramedullary Spinal Melanoma in the Lower Thoracic Spine.

Hering K, Bresch A, Lobsien D, Mueller W, Kortmann RD, Seidel C - Case Rep Oncol Med (2016)

Preoperative sagittal MRI shows the spinal cord tumor at the level of the conus medullaris (arrow). T1-weighted MRI with gadolinium shows high signal intensity relative to that of the cord (a) and T2-weighted MRI shows inhomogenous hypointensive signal (b). Four weeks' follow-up sagittal T1-weighted MRI with gadolinium (c) and T2-weighted MRI (d) and 28 weeks' follow-up T1-weighted MRI with gadolinium (e) and T2-weighted MRI (f) show the residual tumor (arrow).
© Copyright Policy
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC4835629&req=5

fig1: Preoperative sagittal MRI shows the spinal cord tumor at the level of the conus medullaris (arrow). T1-weighted MRI with gadolinium shows high signal intensity relative to that of the cord (a) and T2-weighted MRI shows inhomogenous hypointensive signal (b). Four weeks' follow-up sagittal T1-weighted MRI with gadolinium (c) and T2-weighted MRI (d) and 28 weeks' follow-up T1-weighted MRI with gadolinium (e) and T2-weighted MRI (f) show the residual tumor (arrow).
Mentions: A 57-year-old female patient was admitted for generalized pain in the lower extremities with mild left-sided distal paresis of the left leg and paraesthesia of the left lower leg and foot progressing for 2 months. Spinal magnetic resonance imaging (MRI) showed an intraspinal mass in the region of the lower thoracic spine at the level of the T12 vertebrae. It was hyperintense on gadolinium enhanced T1-weighted images (Figure 1(a)) and inhomogenous and hypointensive on T2-weighted images (Figure 1(b)). A subsequent MRI scan of the brain and entire spine revealed no other suspect lesions. Due to increasing pain, rapid resection was planned for suspected tumor.

Bottom Line: Purpose.Results.Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiotherapy and Radiation Oncology, Leipzig University, Liebigstrasse 20, 04103 Leipzig, Germany.

ABSTRACT

Unlabelled: Background Context. Up to date, only four cases of primary intradural extramedullary spinal cord melanoma (PIEM) have been reported. No previous reports have described a case of PIEM located in the lower thoracic spine with long-term follow-up. Purpose. Demonstrating an unusual, extremely rare case of melanoma manifestation. Study Design.

Case report: Methods. We report a case of a 57-year-old female suffering from increasing lower extremity pain, left-sided paresis, and paraesthesia due to spinal cord compression caused by PIEM in the lower thoracic spine. Results. Extensive investigation excluded other possible primary melanoma sites and metastases. For spinal cord decompression, the tumor at level T12 was resected, yet incompletely. Adjuvant radiotherapy was administered two weeks after surgery. The patient was recurrence-free at 104 weeks after radiotherapy but presents with unchanged neurological symptoms. Conclusion. Primary intradural extramedullary melanoma (PIEM) is extremely rare and its clinical course is unpredictable.

No MeSH data available.


Related in: MedlinePlus