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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

Illustration of the histology (H&E) and immunohistochemistry (HMB-45) of the investigated tumor. Tumor cells are polygonal with prominent nucleoli and partially pigmented (H&E). Tumor cells express the melanoma specific protein HMB-45. Tumor cells were also positive for MELAN-A and S-100 (not shown). Scale bars represent 100 μm; magnification ×400 each.
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fig2: Illustration of the histology (H&E) and immunohistochemistry (HMB-45) of the investigated tumor. Tumor cells are polygonal with prominent nucleoli and partially pigmented (H&E). Tumor cells express the melanoma specific protein HMB-45. Tumor cells were also positive for MELAN-A and S-100 (not shown). Scale bars represent 100 μm; magnification ×400 each.

Mentions: Intraoperatively, an intradural, black, soft, and hypervascularized neoplasm was encountered which diffusely invaded the dura. Instantaneous surgical section of the tumor confirmed a malignant melanoma. Due to diffuse tumoral infiltration and probable severe postoperative deficits the tumor was incompletely removed with decompression of the neurologic structures (Figures 1(c) and 1(d)). The macroscopic aspect of the lesion was that of a malignant pigmented tumor. Histological examination showed spinal cord tissue with an invading black tumor consisting of tight clusters of tumor cells. The cells were polygonal to spindle shaped with intracytoplasmic brown pigment. Nuclear pleomorphism and mitoses were visible. Immunohistochemistry showed S-100 and HMB45 immunopositivity in tumor cells. They were positive for Melan-A with a mib-labeling index ranging from 5% to 10%. Figure 2 illustrates histopathology and immunohistochemistry of the investigated tumor. Pyrosequencing of tumor DNA detected no BRAF V600E mutation.


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)

Illustration of the histology (H&E) and immunohistochemistry (HMB-45) of the investigated tumor. Tumor cells are polygonal with prominent nucleoli and partially pigmented (H&E). Tumor cells express the melanoma specific protein HMB-45. Tumor cells were also positive for MELAN-A and S-100 (not shown). Scale bars represent 100 μm; magnification ×400 each.
© Copyright Policy
Related In: Results  -  Collection

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

fig2: Illustration of the histology (H&E) and immunohistochemistry (HMB-45) of the investigated tumor. Tumor cells are polygonal with prominent nucleoli and partially pigmented (H&E). Tumor cells express the melanoma specific protein HMB-45. Tumor cells were also positive for MELAN-A and S-100 (not shown). Scale bars represent 100 μm; magnification ×400 each.
Mentions: Intraoperatively, an intradural, black, soft, and hypervascularized neoplasm was encountered which diffusely invaded the dura. Instantaneous surgical section of the tumor confirmed a malignant melanoma. Due to diffuse tumoral infiltration and probable severe postoperative deficits the tumor was incompletely removed with decompression of the neurologic structures (Figures 1(c) and 1(d)). The macroscopic aspect of the lesion was that of a malignant pigmented tumor. Histological examination showed spinal cord tissue with an invading black tumor consisting of tight clusters of tumor cells. The cells were polygonal to spindle shaped with intracytoplasmic brown pigment. Nuclear pleomorphism and mitoses were visible. Immunohistochemistry showed S-100 and HMB45 immunopositivity in tumor cells. They were positive for Melan-A with a mib-labeling index ranging from 5% to 10%. Figure 2 illustrates histopathology and immunohistochemistry of the investigated tumor. Pyrosequencing of tumor DNA detected no BRAF V600E mutation.

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