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Hydrocephalus Secondary to Intradural Extramedullary Malignant Melanoma of Spinal Cord.
World Neurosurg. 2019 Oct; 130:222-226.WN

Abstract

BACKGROUND

Hydrocephalus secondary to spinal cord tumors is rare.

CASE DESCRIPTION

We present a 39-year-old male with gradual-onset headache whose initial diagnosis was cerebral aneurysm and communicating hydrocephalus. The correct diagnosis was primary intradural extramedullary malignant melanoma of the spinal cord. Initial brain magnetic resonance imaging demonstrated slight dilation of cerebral ventricles and a 3-mm unruptured anterior communicating artery aneurysm. He was placed under observation therapy. Two months later he was seen again due to severe headache. There was no intracranial hemorrhage on brain computed tomography scans. As we suspected rupture of the aneurysm, we operated on him for surgical clipping; however, there was no aneurysmal rupture. We found no lesions responsible for hydrocephalus, so we placed a ventriculoperitoneal shunt. His headache subsequently resolved. Nine months later he developed gait disturbance; a large volume of ascites was observed. Gadolinium-enhanced lumbar magnetic resonance imaging revealed an intradural extramedullary mass at the L-1 to S-5 level. Cytology and immunohistochemistry of the cerebrospinal fluid and ascites identified a few atypical cells positive for HMB-45, S-100 protein, and Melan-A. Whole-body examinations detected no primary lesions outside the central nervous system. Our final diagnosis was primary intradural extramedullary malignant melanoma of the spinal cord with cerebrospinal fluid dissemination.

CONCLUSIONS

Our findings indicate that communicating hydrocephalus may be due to primary malignant melanoma of the spinal cord.

Authors+Show Affiliations

Department of Neurological Surgery, Nippon Medical School Musashi Kosugi Hospital, Kawasaki, Kanagawa, Japan. Electronic address: s9080@nms.ac.jp.Department of Neurological Surgery, Nippon Medical School Musashi Kosugi Hospital, Kawasaki, Kanagawa, Japan.Department of Neurological Surgery, Nippon Medical School Hospital, Kawasaki, Kanagawa, Japan.Department of Neurological Surgery, Nippon Medical School Musashi Kosugi Hospital, Kawasaki, Kanagawa, Japan.Department of Neurological Surgery, Nippon Medical School Hospital, Kawasaki, Kanagawa, Japan.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

31302270

Citation

Hironaka, Kohei, et al. "Hydrocephalus Secondary to Intradural Extramedullary Malignant Melanoma of Spinal Cord." World Neurosurgery, vol. 130, 2019, pp. 222-226.
Hironaka K, Tateyama K, Tsukiyama A, et al. Hydrocephalus Secondary to Intradural Extramedullary Malignant Melanoma of Spinal Cord. World Neurosurg. 2019;130:222-226.
Hironaka, K., Tateyama, K., Tsukiyama, A., Adachi, K., & Morita, A. (2019). Hydrocephalus Secondary to Intradural Extramedullary Malignant Melanoma of Spinal Cord. World Neurosurgery, 130, 222-226. https://doi.org/10.1016/j.wneu.2019.07.046
Hironaka K, et al. Hydrocephalus Secondary to Intradural Extramedullary Malignant Melanoma of Spinal Cord. World Neurosurg. 2019;130:222-226. PubMed PMID: 31302270.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hydrocephalus Secondary to Intradural Extramedullary Malignant Melanoma of Spinal Cord. AU - Hironaka,Kohei, AU - Tateyama,Kojiro, AU - Tsukiyama,Atsushi, AU - Adachi,Koji, AU - Morita,Akio, Y1 - 2019/07/11/ PY - 2019/04/06/received PY - 2019/07/02/revised PY - 2019/07/03/accepted PY - 2019/7/16/pubmed PY - 2020/1/24/medline PY - 2019/7/15/entrez KW - Hydrocephalus KW - Intradural extramedullary spinal tumor KW - Malignant melanoma KW - Peritoneal metastasis KW - Ventriculoperitoneal shunt SP - 222 EP - 226 JF - World neurosurgery JO - World Neurosurg VL - 130 N2 - BACKGROUND: Hydrocephalus secondary to spinal cord tumors is rare. CASE DESCRIPTION: We present a 39-year-old male with gradual-onset headache whose initial diagnosis was cerebral aneurysm and communicating hydrocephalus. The correct diagnosis was primary intradural extramedullary malignant melanoma of the spinal cord. Initial brain magnetic resonance imaging demonstrated slight dilation of cerebral ventricles and a 3-mm unruptured anterior communicating artery aneurysm. He was placed under observation therapy. Two months later he was seen again due to severe headache. There was no intracranial hemorrhage on brain computed tomography scans. As we suspected rupture of the aneurysm, we operated on him for surgical clipping; however, there was no aneurysmal rupture. We found no lesions responsible for hydrocephalus, so we placed a ventriculoperitoneal shunt. His headache subsequently resolved. Nine months later he developed gait disturbance; a large volume of ascites was observed. Gadolinium-enhanced lumbar magnetic resonance imaging revealed an intradural extramedullary mass at the L-1 to S-5 level. Cytology and immunohistochemistry of the cerebrospinal fluid and ascites identified a few atypical cells positive for HMB-45, S-100 protein, and Melan-A. Whole-body examinations detected no primary lesions outside the central nervous system. Our final diagnosis was primary intradural extramedullary malignant melanoma of the spinal cord with cerebrospinal fluid dissemination. CONCLUSIONS: Our findings indicate that communicating hydrocephalus may be due to primary malignant melanoma of the spinal cord. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/31302270/Hydrocephalus_Secondary_to_Intradural_Extramedullary_Malignant_Melanoma_of_Spinal_Cord_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(19)31952-7 DB - PRIME DP - Unbound Medicine ER -