Li XJ, Yang L, Yan XF, Zhan CT, Liu JH. Granulomatosis with polyangiitis presenting as high fever with diffuse alveolar hemorrhage and otitis media: A case report. World J Clin Cases 2021; 9(10): 2344-2351 [PMID: 33869612 DOI: 10.12998/wjcc.v9.i10.2344]
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05912523
Submitted on:
April 06, 2021, 14:34
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Reader Comments:
Malignant melanoma most often occurs in the skin. Intraspinal malignant melanoma is quite rare. It is mainly distributed in the cervical segment, followed by the thoracic segment and thoracolumbar junction segment. This study analyzed and discussed the clinical, pathological, imaging data and treatment of this case of lumbar melanoma.
The MRI features of melanoma vary with the proportion of melanocytes in the tumor.The diagnosis of this disease depends on puncture or surgical pathology.Because malignant melanoma in spinal canal is very rare, and its imaging manifestations are variable, it mainly needs to be differentiated from schwannoma and meningioma in spinal canal. In addition, hemorrhagic malignant melanoma should be differentiated from epidural hematoma and lipoma. For other rare intramedullary spinal cord tumors in this group, careful separation along the tumor interface is also required during microsurgical resection.However, it is often difficult to completely remove the tumor during the operation. The use of high-power microscope and ultrasonic scalpel is helpful to completely remove the tumor, and greatly improves the safety of the operation.For high-grade malignant tumors, excessive resection should not be pursued when the peritumoral interface is unclear. Postoperative radiotherapy or targeted therapy or immunotherapy based on gene detection can be considered to prolong the disease-free survival or overall survival rate. Neurophysiological monitoring and intraoperative ultrasound accurate positioning have become one of the routine intraoperative auxiliary means in neurosurgery. It is of great significance to guide accurate tumor resection, avoid spinal cord injury and improve postoperative neurological function.
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