Journal de la colonne vertébrale

Primary Melanocytomas of the Spinal Cord: Case Studies and Rehabilitation Perspectives

Abstract

Stephen Covington, Matthew Severson, Patrick Shaeffer, Derek McGaffey and Kristin Garlanger

Primary melanocytomas of the central nervous system are rare tumors arising from leptomeningeal melanocytes. Only 29 cases have been reported in the literature to date. Presenting symptoms may include insidious onset of back pain, slowly progressive neurological deficits such as weakness and sensory changes, in addition to bowel and bladder dysregulation. Advanced imaging including magnetic resonance imaging can be helpful in lesion localization but does not distinguish between primary and metastatic melanoma. In this case series, we present three patients with non-traumatic spinal cord injuries secondary to primary CNS malignant melanocytomas, who were admitted to a single inpatient rehabilitation facility within a 12-month time frame. These cases highlight the importance of the rehabilitation team in the continuum of care for patients undergoing resection of primary melanocytomas of the spinal cord. The rehabilitation team should be involved in the pre-operative counseling setting, immediately post-operatively and in follow up care. A comprehensive multidisciplinary approach including physical and occupational therapists, rehabilitation nurses, rehabilitation neuropsychologists and physiatrists is important for recovery of these patients.