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Case Report

Primary malignant melanoma of the spinal cord: a case report

Ashutosh Das Sharma, Jyoti Poddar, Ubrangala Suryanarayan Kunikullaya, Jay Prakash Neema
Department of Radiotherapy, Gujarat Cancer and Research Institute, Asarwa 380016, Ahmedabad, India.
Correspondence to: Dr. Ashutosh Das Sharma, Department of Radiotherapy, Gujarat Cancer and Research Institute, Asarwa 380016, Ahmedabad, India.
E-mail: sharmaashutoshdas@gmail.com

A B S T R AC T
Primary malignant melanoma of the central nervous system is rare, and the events involving the spinal cord are even more
infrequent. A 30-year-old male presented with a mass lesion of the spinal cord. After radiological workup, the mass was resected
in December 2012. The histopathological examination report and immunohistochemistry suggested malignant melanoma. PET-CT
scan, brain MRI, and funduscopic examination did not reveal malignant melanoma elsewhere in the body. The patient received
postoperative radiotherapy until March 2013. Presently, the patient is asymptomatic with normal neurological functions.

Key words: Malignant melanoma; cervical spine; spinal cord; intramedullary; central nervous system

INTRODUCTION in size and was hyper to hypointense on T1 and isointense
on T2 weighted images.
Primary malignant melanoma of the central nervous system
(CNS) is rare, with less than 60 cases reported in the The patient underwent laminectomy and surgical excision
literature; a disease that presents substantial diagnostic, and decompression on November 26th 2012. No residual
[1]

prognostic and therapeutic challenges. We report a case of lesion was found on postoperative MRI scan.
primary malignant melanoma of the spinal cord which was
treated successfully with surgery and adjuvant radiation The histopathological examination showed clusters
therapy (RT). of atypical spindle cells with prominent nucleoli and
eosinophilic cytoplasm [Figure 3], with evident intra- and
CASE REPORT extracellular pigment deposition. Immunohistochemistry
staining showed positivity for HMB-45 [Figure 4], S-100
A 30 years old male presented with complaints of pain/
stiffness in the neck and numbness/weakness in all four [Figure 5], and Melan-A [Figure 6]; all consistent with the
limbs. The symptoms had been present for 90 days and histopathological diagnosis of malignant melanoma.
were gradually progressing.
A thorough systemic survey was done including PET scan,
Magnetic resonance imaging (MRI) scan of the cervical tumor markers, ophthalmological, and dermatological
spine [Figures 1 and 2] showed an intradural extramedullary examinations. These did not reveal any other foci of
enhancing mass lesion at the second and third cervical melanoma, leading to the diagnosis of primary spinal
vertebral level, compressing the spinal cord with focal cord malignant melanoma. The patient received postoperative
edema and anterior-right lateral displacement of the spinal RT (50 Gray in 25 fractions on a linear accelerator with 6
cord. The lesion measured 14 × 17 × 29 mm in size and MV photons by parallel opposed portals) from January 3rd
was hyperintense on T1 and hypointense on T2 weighted to February 13th 2013. Since then, the patient has been on
images. Another intradural extramedullary mass lesion was regular follow up with normal neurological functions.
found at the craniovertebral level, indenting the cervico-
medullary junction. This lesion measured 13 × 18 × 16 mm This is an open access article distributed under the terms of the Creative
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How to cite this article: Sharma AD, Poddar J, Kunikullaya US,
Neema JP. Primary malignant melanoma of the spinal cord: a case
DOI: report. J Cancer Metastasis Treat 2016;2:144-6.
10.20517/2394-4722.2015.58
Received: 12-08-2015; Accepted: 19-12-2015.

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