Abstract
The following case report concerns a rare spinal metastasis of malignant melanoma occuring in the 2nd lumbar vertebra. A 35-year old female was admitted to our hospital with the complaint of severe lumbago and weakness of both lower extremities for 5 months. She had her right eye enucleated due to choroid melanoma thirteen years ago and has been conservatively treated for multiple hemangioma in the liver since 3 years ago. Preoperative plain roentgenogram showed markedly compressed pathologic fracture of the second lumbar vertebral body and there was photon deficiency on that area, in the Tc-99m radionuclide bone scan, which was suggestive of highly aggressive lesion. Magnetic resonance imaging study showed expansile mass lesion, which was projected into the spinal canal to obstruct it and revealed high signal intensity in T1-weighted image as well as T2-weighted image which was compatible with melanoma or other vasular lesions including hemangioma. After preoperative embolization of the hypervascular lesion on the lumbar segmental arteriogram, we performed the intralesional curettage and decompression of the spinal cord through the anterior retroperitoneal approach. The lesion was pathologically compatible with malignant melanoma. The patient was able to ambulate without pain and there was improvement of the muscle weakness after the operation.