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Home > Journals > Journal of Neurosurgical Sciences > Past Issues > Journal of Neurosurgical Sciences 2007 December;51(4) > Journal of Neurosurgical Sciences 2007 December;51(4):181-3



A Journal on Neurosurgery

Indexed/Abstracted in: e-psyche, EMBASE, PubMed/MEDLINE, Neuroscience Citation Index, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,651

Frequency: Bi-Monthly

ISSN 0390-5616

Online ISSN 1827-1855


Journal of Neurosurgical Sciences 2007 December;51(4):181-3


Primary hemorrhagic intramedullary melanoma. Case report with emphasis on the difficult preoperative diagnosis

Denaro L. 1, Pallini R. 1, Di Muro L. 1, Ciampini A. 1, Vellone V. 2, Lauretti L. 1, Fernandez E.1, Maira G. 1

1 Department of Neurosurgery Catholic University School of Medicine, Rome, Italy
2 Department of Pathology Catholic University School of Medicine, Rome, Italy

Primary melanoma of the central nervous system (CNS) is rare and primary spinal melanoma (PSM) is even more unusual. Preoperative diagnosis of melanocytic lesion as a PSM is difficult, because of the heterogeneous magnetic resonance (MR) signal intensity, due to hemorrhagic foci and melanin deposits. We describe the case of a 68 year-old male with a MR showing at Th8-Th9 level a well-defined intramedullary lesion; for the characteristics of hemorrhagic signal on MR and its association with a presumptive brain cavernoma, a preoperative diagnosis of intramedullary cavernous angioma was suspected. Pathological examination revealed a melanoma, and for the absence of other localizations outside the spinal cord, a diagnosis of primary spinal melanoma was established. The growth of PSM is slower and survival is longer than in the most common spinal metastasis from skin melanoma. Patients who undergo surgical excision, alone or associated with additional treatments, often show a long survival. We report this case to underline the importance and difficulties concerning the preoperative diagnosis of a hemorrhagic intramedullary lesion.

language: English


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