Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 7, 2022; 10(1): 381-387
Published online Jan 7, 2022. doi: 10.12998/wjcc.v10.i1.381
An atypical primary malignant melanoma arising from the cervical nerve root: A case report and review of literture
Yi-Feng Shi, Yu-Qi Chen, Hai-Feng Chen, Xin Hu
Yi-Feng Shi, Yu-Qi Chen, Hai-Feng Chen, Xin Hu, Department of Neurosurgery, West China Hospital, Chengdu 610041, Sichuan Province, China
Author contributions: Shi YF drafted the article or made critical revisions related to the important intellectual content of the manuscript; Chen YQ analyzed and interpreted the data; designed the research study; Chen HF approved the final version of the article to be published; Hu X provided substantial contributions to conception and design of the study; All authors issued final approval for the version to be submitted.
Informed consent statement: Informed consent was provided by the patient and his close relatives for the publication of this report and any accompanying images.
Conflict-of-interest statement: There is no conflict of interest related to the manuscript.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin Hu, MD, Neurosurgeon, Department of Neurosurgery, West China Hospital, No. 37 Guo Xue Xiang, Wu Hou District, Chengdu 610041, Sichuan Province, China.huxingxxy@gmail.com
Received: August 21, 2021
Peer-review started: August 21, 2021
First decision: September 29, 2021
Revised: October 29, 2021
Accepted: November 30, 2021
Article in press: November 30, 2021
Published online: January 7, 2022
Processing time: 130 Days and 17.8 Hours
Abstract
BACKGROUND

Primary melanomas affecting the central nervous system are very rare, and melanomas originating in the spinal canal or origin of the spinal nerve root are even rarer. As a consequence, not much is known about this.

CASE SUMMARY

Here we report a case of primary malignant melanoma originating in the cervical spinal cord nerve root. A 64-year-old woman presented with symptoms of numbness in the right side of the neck, pain, and hypoesthesia in the right upper limb which persisted for 1 year. Neurological examination showed that the superficial sensation in the right upper limb had decreased with muscle strength of grade 4. Magnetic resonance imaging examination revealed a mass (approximately 2.5 cm × 1.4 cm × 1 cm) in the right side of the spinal canal in the C-2 plane. Based on findings obtained during operation, perioperative examination, pathological diagnosis, and the diagnostic criteria of primary central melanoma proposed by Hayward, the mass was confirmed to be a melanoma of intraspinal nerve root origin.

CONCLUSION

This is the first case of primary malignant melanoma originating from cervical spinal cord nerve roots and spread along the inside and outside of the spinal canal. The clinical relevance of this case is discussed to provide new insights into the differential diagnosis of intraspinal tumours. Further studies are needed to better understand the mechanisms driving the growth pattern and development of this type of tumour.

Keywords: Spinal cord; Primary melanoma; Nerve root; Primary neoplasm; Case report

Core Tip: Primary malignant melanoma arising from the cervical nerve root, and spreading along the inside and outside regions of the spinal canal is clinically rare. The clinical symptoms and imaging features of this case are atypical and can easily be misdiagnosed. In this case report, additional clinical characteristics and differential diagnoses are presented.