Skip to main content

Advertisement

SpringerLink
Log in

Bifocal extra- and intradural melanocytoma of the spine: case report and literature review

  • Case Report
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Background

Spinal melanocytoma is one of the most infrequent space-occupying lesions of the central nervous system. To the best of our knowledge, this is the first report of primary bifocal intradural melanocytoma of heterogenous pathological grade to date.

Case description

We report the case of a 43-year old patient with primary bifocal melanocytoma, clinically and radiologically resembling benign schwannoma. The patient presented with myeloradiculopathy of the left C3 dermatome. Magnetic resonance imaging of the upper spine revealed two space-occupying lesions with paraspinal extension, initially diagnosed as neurofibroma. Definitive histopathological classification of both lesions was melanocytoma. Both tumours were only partially removed due to adherence to surrounding structures. The patient underwent stereotactic external beam irradiation (EBR). Follow-up at 1 year after surgery revealed no recurrence and the patient remained free of symptoms. The clinical, radiological and pathological features of this rare tumour entity are presented and the available literature is reviewed.

Conclusions

Intradural melanocytoma, although exceedingly rare, requires a thorough work-up to exclude malignant melanoma. With only two previous reports of multifocal melanocytoma published in the literature, standard therapy has not yet been established and complete surgical removal remains the modality of choice. Patients should be closely monitored to detect local recurrence or malignant degeneration. EBR may be considered in cases where total excision is not achievable and reduces risk of local recurrences.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Abbreviations

CNS:

Central nervous system

MC:

Melanocytoma

MRI:

Magnetic resonance imaging

EBR:

External beam irradiation

GTR:

Gross total resection

CT:

Computed tomography

HE:

Haematoxylin–eosin

References

  1. Ali Y, Rahme R, Moussa R, Abadjian G, Menassa-Moussa L, Samaha E (2009) Multifocal meningeal melanocytoma: a new pathological entity or the result of leptomeningeal seeding? J Neurosurg 111(3):488–491

    Article  PubMed  Google Scholar 

  2. Azarpira N, Torabineghad S, Sepidbakht S, Rakei M, Bagheri MH (2009) Cytologic findings in pigmented melanotic schwannoma: a case report. Acta Cytol 53(1):113–115

    Article  PubMed  Google Scholar 

  3. Brat DJ, Giannini C, Scheithauer BW, Burger PC (1999) Primary melanocytic neoplasms of the central nervous systems. Am J Surg Pathol 23(7):745–754

    Article  PubMed  CAS  Google Scholar 

  4. Classen J, Hehr T, Paulus W, Plate K, Bamberg M (2002) Suprasellar melanocytoma: a case of primary radiotherapy and review of the literature. J Neurooncol 58(1):39–46

    Article  PubMed  Google Scholar 

  5. El-Khashab M, Koral K, Bowers DC, Johnson-Welch S, Swift D, Nejat F (2009) Intermediate grade meningeal melanocytoma of cervical spine. Child’s Nerv Syst 25:407–410

    Article  Google Scholar 

  6. Eskandari R, Schmidt MH (2010) Intramedullary spinal melanocytoma. Rare Tumors 2(2):e24

    PubMed  Google Scholar 

  7. Franken SPG, Setz-Pels W, Smink-Bol M et al (2009) Unusual case of bifocal leptomeningeal melanocytoma in the posterior fossa with seeding in the spinal canal. Br J Radiol 82(981):e182–e188

    Article  PubMed  CAS  Google Scholar 

  8. Gempt J, Buchmann N, Grams AE et al (2010) Black brain: transformation of a melanocytoma with diffuse melanocytosis into a primary cerebral melanoma. J Neurooncol 102:323–328

    Article  PubMed  Google Scholar 

  9. Goyal A, Sinha S, Singh AK, Tatke M, Kansal A (2003) Lumbar spinal meningeal melanocytoma of the l3 nerve root with paraspinal extension: a case report. Spine 28(7):E140–E142

    PubMed  Google Scholar 

  10. Hodis E, Watson IR, Kryukov GV et al (2012) A landscape of driver mutations in melanoma. Cell 150(2):251–263

    Article  PubMed  CAS  Google Scholar 

  11. Horn EM, Nakaji P, Coons SW, Dickman CA (2008) Surgical treatment for intramedullary spinal cord melanocytomas. JNS Spine 9:48–54

    Google Scholar 

  12. Jaiswal S, Tungria A, Srivastava A, Vij M, Jaiswal A, Behari S (2011) Primary melanocytic tumors of the central nervous system: a neuroradiological and clinicopathological study of five cases and brief review of literature. Neurol India 59:413

    Article  PubMed  Google Scholar 

  13. Karikari IO, Powers CJ, Bagley CA, Cummings TJ, Radhakrishnan S, Friedman AH (2009) Primary intramedullary melanocytoma of the spinal cord. Neurosurgery 64:E777–E778

    Article  PubMed  Google Scholar 

  14. Kurita H, Segawa H, Shin M et al (2000) Radiosurgery of meningeal melanocytoma. J Neurooncol 46(1):57–61

    Article  PubMed  CAS  Google Scholar 

  15. Liubinas SV, Maartens N, Drummond KJ (2010) Primary melanocytic neoplasms of the central nervous system. J Clin Neurosci 17(10):1227–1232

    Article  PubMed  Google Scholar 

  16. Merciadri P, Secci F, Sbaffi P, Zona G (2011) Multifocal meningeal melanocytoma of the conus medullaris. Acta Neurochir 153(11):2283–2285

    Article  PubMed  Google Scholar 

  17. Muthappan M, Muthu T, Hussain Z, Lamont D, Balakrishnan V (2012) Cervical intramedullary melanocytoma: a case report and review of literature. J Clin Neurosci 19(10):1450–1453

    Article  PubMed  CAS  Google Scholar 

  18. Painter TJ, Chaljub G, Sethi R, Singh H, Gelman B (2000) Intracranial and intraspinal meningeal melanocytosis. AJNR Am J Neuroradiol 21(7):1349–1353

    PubMed  CAS  Google Scholar 

  19. Perrini P, Caniglia M, Pieroni M, Castagna M, Parenti GF (2010) Malignant transformation of intramedullary melanocytoma. Neurosurgery 67:E867–E869

    Article  PubMed  Google Scholar 

  20. Rades D, Schild SE (2005) Dose–response relationship for fractionated irradiation in the treatment of spinal meningeal melanocytomas: a review of the literature. J Neurooncol 77:311–314

    Article  PubMed  Google Scholar 

  21. Roser F, Nakamura M, Brandis A, Hans V, Vorkapic P, Samii M (2004) Transition from meningeal melanocytoma to primary cerebral melanoma. JNS 101(3):528–531

    Google Scholar 

  22. Scheithauer BW, Erdogan S, Rodriguez FJ et al (2009) Malignant peripheral nerve sheath tumors of cranial nerves and intracranial contents. Am J Surg Pathol 33:325–338

    Article  PubMed  Google Scholar 

  23. Smith AB, Rushing EJ, Smirniotopoulos JG (2009) Pigmented lesions of the central nervous system: radiologic-pathologic correlation. Radiographics 29(5):1503–1524

    Article  PubMed  Google Scholar 

  24. Turhan T, Oner K, Yurtseven T, Akalin T, Ovul I (2004) Spinal meningeal melanocytoma. Report of two cases and review of the literature. J Neurosurg 100(3 Suppl Spine):287–290

    Google Scholar 

Download references

Conflict of interest

The authors report no conflict of interest concerning the materials or methods used in this study or findings specified in this paper.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, University Hospital Zurich, Frauenklinikstrasse 1, 8032, Zurich, Switzerland

    Niels A. Foit, Marian C. Neidert, Christoph M. Woernle & Niklaus Krayenbühl

  2. Department of Neuropathology, University Hospital Zurich, Frauenklinikstrasse 10, 8032, Zurich, Switzerland

    Elisabeth J. Rushing

Authors
  1. Niels A. Foit
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marian C. Neidert
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christoph M. Woernle
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Elisabeth J. Rushing
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Niklaus Krayenbühl
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Niels A. Foit.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Foit, N.A., Neidert, M.C., Woernle, C.M. et al. Bifocal extra- and intradural melanocytoma of the spine: case report and literature review. Eur Spine J 22 (Suppl 3), 521–525 (2013). https://doi.org/10.1007/s00586-013-2773-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-013-2773-x

Keywords

Search

Navigation