Publikation

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

Wissenschaftlicher Artikel/Review - 13.04.2013

Bereiche
PubMed
DOI

Zitation
Foit N, Neidert M, Woernle C, Rushing E, Krayenbühl N. Bifocal extra- and intradural melanocytoma of the spine: case report and literature review. Eur Spine J 2013; 22 Suppl 3:S521-5.
Art
Wissenschaftlicher Artikel/Review (Englisch)
Zeitschrift
Eur Spine J 2013; 22 Suppl 3
Veröffentlichungsdatum
13.04.2013
eISSN (Online)
1432-0932
Seiten
S521-5
Kurzbeschreibung/Zielsetzung

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 heterogeneous 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.