A. Ku et al., LUMBOSACRAL RADICULOPATHY SECONDARY TO L5 METASTATIC MELANOMA OF UNKNOWN PRIMARY, Archives of physical medicine and rehabilitation, 77(3), 1996, pp. 307-309
Lumbosacral radiculopathy secondary to spinal malignancy is rare. Spin
al melanoma without cutaneous manifestations is even more unusual. We
present the case of a 45-year-old physician with a history of degenera
tive disease of lumbar spine and chronic back pain who presented with
increasing back pain with right radiculopathy despite conservative man
agement for 6 months. Computed tomography showed a destructive lesion
of the L5 vertebral body. Results from a biopsy guided by computed tom
ography suggested neoplasm of unknown origin. The patient underwent an
terior vertebrectomy with instrumentation and fusion. Surgical patholo
gy study results showed metastatic melanoma of unknown primary. The pa
tient had no cutaneous manifestation of the disease. This is the first
reported case of radiculopathy due to melanoma metastatic to the lumb
ar spine. In view of the atypical presentation of our patient's malign
ancy, we emphasize the importance of including malignancy of lumbar sp
ine in the differential diagnosis of progressive lower back pain with
radiculopathy. (C) 1996 by the American Congress of Rehabilitation Med
icine and the American Academy of Physical Medicine and Rehabilitation