Primary Extradural Melanoma Arising in Cervical Spinal Nerve Root.

Primary Extradural Melanoma Arising in Cervical Spinal Nerve Root.

World Neurosurg. 2017 Dec 27;:

Authors: Zou C, Cheng W, Zhu C, Guo Q, Wu A

Abstract
BACKGROUND: Primary cervical melanoma is rare; this is especially true of extradural melanoma arising in the nerve root. Characterizing these cases can provide a basis for improved melanoma management.
CASE DESCRIPTION: A 42-year-old female patient with numbness and pain in the right shoulder and arm persisting for 5 years was admitted. Preoperative magnetic resonance imaging revealed an epidural ladle-shaped mass shape beyond the C7-T1 intervertebral foramen that resembleda nerve sheath tumor. Histopathologic analysis following complete resection confirmed the lesion as malignant melanoma. Radiotherapy and temozolomide and cisplatin chemotherapy were administered in an accompanying hospital with regular follow-ups atour institution. After 2 months of postoperative adjuvant therapy, hepatic metastatic lesions developed. The chemotherapy regimen was changed to carboplatin, nab-paclitaxel, and recombinant human endostatin injections for a 6-month period. A follow-up 8months after chemotherapy (16 months post-surgery) indicated a good prognosis.
CONCLUSIONS: In the past 10 years only one case of primary extradural spinal melanoma incervical intervertebral foramen has been described, with no reported cases of hepatic metastasis. As radiographic results are not unequivocal, a diagnosis of spinal melanoma must be based on post-operative histological confirmation. However, to date there is no standard post-operative adjuvant therapy for these patients. The chemotherapy regimen described in this report has broader implications for melanoma treatment.

PMID: 29288844 [PubMed - as supplied by publisher]

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