A Descriptive Analysis of Spinal Melanocytoma in Current Literature: Review of Clinical Presentations, Treatment Regiments, and Histological Parameters
Mehdi Rizk, B.S.: No financial relationships to disclose
Introduction: Melanocytomas are benign CNS neoplasms that are locally aggressive and can present within the spinal canal. Clinical manifestations generally lead to focal neurological deficits. Complete surgical resection is the recommended treatment and often provides the most favorable prognosis. Diagnosis of melanocytomas relies on immunohistochemical markers such as S-100, Melan-A, and HMB-45. Our review of current literature on intraspinal melanocytomas aims to describe the demographic variables, clinical manifestations and treatments, histological parameters, and outcomes of the disease.
Methods: A literature search was conducted using the PubMed database from 1978 to 2024 for relevant English-language publications. The key search terms were (melanocytoma) AND ((spinal) OR (spine)). All retrieved publications underwent an initial screening process by the research team to remove any duplicate articles, as well as sources where access to the full publication was not possible. After this initial screening, our team identified relevant inclusion and exclusion criteria to further refine our dataset.
Results: There was a total of 102 patients extracted from 80 included studies, with 56 males and 46 females. The average age of a patient in our analysis was 47.68, ranging from 14 to 79 years old. Most patients’ lesions were located either within the thoracic (n=55, 53.9%) or cervical (n=37, 36.3%) spine. Surgical outcomes were primarily split between subtotal (32.6%) and gross total (58.7%) resection. 26 (32.9%) patients reported tumor recurrence. Only 21 cases had specific mentions of the pursuit of radiotherapy, in which 40.9% of patients did. 62.7% of patients with reported post-operative symptomology had complete symptom resolution. Primary lesion grading was only described for 29 patients, with 7 (24.1%) described as “low” and 22 (75.9%) described as “intermediate.” A positive reaction to the S-100 stain was described in 75 out of 79 reported values (94.9%). Epithelial Membrane Antigen (EMA) stain positivity was described in 3 out of 57 patients (5.3%). HMB-45 positivity was described in 70 out of 71 patients.
Conclusion : Intraspinal melanocytomas are rare and have been minimally analyzed. Our analysis has shown the need for more thorough descriptions of cases of melanocytomas in future research to allow for the capability of a more precise review and analysis.