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CC BY-NC-ND 4.0 · Asian J Neurosurg 2024; 19(03): 540-550
DOI: 10.1055/s-0044-1787081
Case Report

Primary Spinal Malignant Melanoma Mimicking a Cervical Nerve Root Schwannoma: Case Report and Literature Review

Justin Gold
1   Department of Neurological Surgery, Cooper Medical of Rowan University, Camden, New Jersey, United States
,
Nick R. Hernandez
2   Department of Neurosurgery, Robert Wood Johnson Hospital, New Brunswick, New Jersey, United States
,
Timothy Wong
2   Department of Neurosurgery, Robert Wood Johnson Hospital, New Brunswick, New Jersey, United States
,
Nitesh Patel
2   Department of Neurosurgery, Robert Wood Johnson Hospital, New Brunswick, New Jersey, United States
,
Joseph Weiner
3   Department of Radiation Oncology, Robert Wood Johnson Hospital, New Brunswick, New Jersey, United States
,
Simon Hanft
4   Department of Neurological Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York, United States
› Author Affiliations Funding None.
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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.

Keywords

spine surgery - malignant melanoma - nerve root - case report - schwannoma


Publication History

Article published online:
27 May 2024

© 2024. 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/)

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