Primary malignant melanoma, an atypical presentation in the cervical spine: a case report.

Journal: Journal of medical case reports

Volume: 17

Issue: 1

Year of Publication: 2023

Affiliated Institutions:  Department of Surgery, Neurosurgery, College of Medicine, Makerere University, Kampala, Uganda. kamabularry@gmail.com. Faculty of Medicine, Université Catholique du Graben, Butembo, Democratic Republic of the Congo. Department of Internal Medicine, Masereka General Hospital, Goma, North-Kivu, Democratic Republic of the Congo. Department of Surgery, Neurosurgery, College of Medicine, Makerere University, Kampala, Uganda.

Abstract summary 

Few studies have documented the occurrence of melanoma in the cervical spine. Of all malignant melanoma cases, 1% are primary melanoma of the central nervous system, which makes it extremely uncommon and nonspecific. We aim to report a case of the uncommon presentation of primary melanoma in the cervical spine.The patient was a 59-year-old Muganda male who presented with a 2-year history of anterior neck swelling as well as severe pain and a tingling sensation in the left shoulder and arm, which worsened in the recent 6 months. He developed weakness and paresthesia in the upper left arm and progressive gait disturbance of the left leg. A physical examination revealed masses in the left cervical and right submandibular region. Additionally, the upper and lower left extremities revealed hemiparesis and hemihypoesthesia. A magnetic resonance imaging scan showed a hyperintense lesion on TIWI and another hypointense lesion on T2WI, originating from the cervical spine and involving the vertebral bodies and paravertebral soft tissues. The patient underwent surgery, a black tumor was extracted, and histology revealed the tumor to be malignant melanoma. The patient died within 1 month after the diagnosis and surgery.This case is presented to highlight the significance and challenges associated with making a pre- and postoperative diagnosis of primary cervical melanoma with atypical radiological characteristics. Patients with extradural lesions that show hyperintensity on T1-weighted images and hypointensity on T2-weighted images should have spinal melanoma examined as a possible differential diagnosis.

Authors & Co-authors:  Kamabu Larrey Kasereka LK Kataka Louange Maha LM Vivalya Bives Mutume Nzanzu BMN Sikakulya Franck Katembo FK Lekuya Hervé Monka HM Galukande Moses M

Study Outcome 

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Statistics
Citations :  Naing A, Messina JL, Vrionis FR, Daud AI. Uncommon manifestations of common malignancies CASE 3. Malignant melanoma arising from a spinal nerve root. J Clin Oncol. 2004;22(15):3194–3195. doi: 10.1200/JCO.2004.09.021.
Authors :  6
Identifiers
Doi : 548
SSN : 1752-1947
Study Population
Male
Mesh Terms
Humans
Other Terms
Cervical spine;MRI;Malignant melanoma
Study Design
Study Approach
Country of Study
Uganda
Publication Country
England