CC BY-NC-ND 4.0 · IJNS 2017; 06(01): 055-058
DOI: 10.1055/s-0036-1584589
Case Report
Thieme Medical and Scientific Publishers Private Ltd.

Intradural Intramedullary Primary Spinal Melanocytoma: A Rare Case Report

Sudhir Ganesan
1  Ortho Spine Department, Sir Ganga Ram Hospital, New Delhi, India
,
Shankar Acharya
1  Ortho Spine Department, Sir Ganga Ram Hospital, New Delhi, India
,
K. L. Kalra
1  Ortho Spine Department, Sir Ganga Ram Hospital, New Delhi, India
,
Rupinder Chahal
1  Ortho Spine Department, Sir Ganga Ram Hospital, New Delhi, India
› Author Affiliations
Further Information

Publication History

28 December 2015

10 February 2016

Publication Date:
26 July 2016 (online)

  

Abstract

Spinal melanocytomas are rare pigmented tumors of the central nervous system commonly affecting females in their fifth decades. It has been reported in various locations with intradural intramedullary being the rarest. Patients can present with varied symptomatology from mild backache to frank myelopathy. Here we report a case of 34-year-old man with no medical comorbidities with vague backache associated with numbness of anterior aspect of right thigh for 1 year aggravated by activities and relieved by rest. His neurologic examination revealed normal power and sensation in both lower limbs except for decreased temperature sensation in right L2 dermatome. MRI of dorsolumbar spine revealed a well-defined lesion that was hyperintense in T1- and hypointense in T2-weighted image at D11–12 region with uniform bright enhancement in gadolinium-enhanced T1 image. The patient underwent laminectomy of D11 and D12, and an en bloc excision was done. Diagnosis of primary intradural intramedullary melanocytoma was made from histopathologic examination. Spinal melanocytomas should be considered as a differential diagnosis for intradural space-occupying lesions. MRI remains the investigation of choice for diagnosis, but histopathologic examination is required to confirm and differentiate from other pigmented tumors and malignant melanomas. Total surgical excision of the tumor remains the standard treatment with radiotherapy reserved for cases of incomplete excision and recurrences.