PRIMARY INTRAMEDULLARY MELANOMA - ONE CAS E AND A REVIEW OF THE LITERATURE

Primary melanoma is a rare spinal tumour first reported by Hirschberg in 1906. Since then, only 34 cases have been reported. Whe present her e a new case of primary intramedullary thoracic melanoma developed in a 64-year old male patient. MRI showed a paramagnetic signal with reac tive cysts. Macroscopy and histology confirmed the diagnosis. Spinal c ord melanoma is presumed to be primary when no other melanoma is found outside the CNS. The tumour is often located in the middle or lower t horacic cord, may be intra- or extra-medullary and leptomeningeal or e xtradural. It frequently progresses slowly. MRI is the essential exami nation as it demonstrates a lesion with paramagnetic properties. Its i mage is not specific and may correspond to other pigmented tumours (me ningeal melanocytoma, melanotic schwannoma), to a lipoma or to a vascu lar or tumoral haemorrhagic lesion. Treatment is uncertain, but surger y is frequently associated with radiation. Postoperative follow-up aim s at detecting a local regrowth of the tumour or leptomeningeal dissem ination which affects the prognosis.