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Acta Neurochirurgica

, Volume 95, Issue 3–4, pp 147–154 | Cite as

Intraspinal pigmented schwannoma with malignant progression

  • M. Röyttä
  • J. Elfversson
  • H. Kalimo
Special Cases

Summary

A case with recurrent pigmented intraspinal tumour with malignant progression is presented. The primary tumour grew around the nerveroots T9 and T10, was attached to dura and infiltrated the vertebral bone tissue. On light microscopy it was comprised of monomorphic cells with large amount of cytoplasmic pigment and many large pigmented globoid bodies. Mitoses were not observed. On electron microscopy, in addition to cytoplasmic melanosomes of regular size, macromelanosomes were numerous. The tumour cells were surrounded partially by basement membrane like material. On these bases a histological diagnosis of benign pigmented tumour of neural crest origin was suggested (a possible pigmented meningioma or pigmented schwannoma). The patient got a recurrence one year after the primary operation. Biopsy from the re-operation showed histologically the same type of tumour with more pleomorphic cells. Subsequently, the tumour grew progressively and metastases were observed in the lungs and in the skin. The patient died two years after the primary operation. The malignant progression of the tumour and other reports on similar tumours was most consistent with a diagnosis of malignant pigmented schwannoma and this was confirmed later on with immunohistochemical staining showing positive staining for basement membrane components, collagen type IV and laminin as well as a positive staining for S-100 protein. The present findings show that despite benign histological features these tumours can behave very aggressively and stress the need of more information on this type of tumour.

Keywords

Intraspinal tumour pigmented schwannoma pigmented meningioma malignant melanoma 

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References

  1. 1.
    Abbott M, Killeffer FA, Crandall PH (1968) Melanotic meningioma. Case report. J Neurosurg 29: 283–286PubMedGoogle Scholar
  2. 2.
    Bagnara JT, Matsumoto J, Ferris W, Frost SK, Turner NA, Tchen TT, Taylor JP (1979) Common origin of pigmented cells. Science 203: 410–415PubMedGoogle Scholar
  3. 3.
    Bakody JT, Hazard JB, Gardner WJ (1950) Pigmented tumors of the central nervous system. Cleve Clin Q 17: 89–101Google Scholar
  4. 4.
    Chen KTK, Latorraca R, Rabich D, Padgug A, Hatez GR, Gilbert EF (1980) Malignant schwannoma. A light microscopic and ultrastructural study. Cancer 45: 1585–1593PubMedGoogle Scholar
  5. 5.
    Enzinger FM, Weiss SW (1983) Soft tissue tumors. The C.V. Mosby, Company, St. Louis Toronto LondonGoogle Scholar
  6. 6.
    Font RL, Truong LD (1984) Melanotic schwannoma of soft tissues. Electron-microscopic observations and review of literature. Am J Surg Pathol 8: 129–138PubMedGoogle Scholar
  7. 7.
    Ghadially FN (1982) Ultrastructural pathology of the cell and matrix. Butterworths, London Boston Sydney Wellington Durban TorontoGoogle Scholar
  8. 8.
    Gibson JG, Burrows D, Weir WP (1957) Primary melanoma of the meninges. J Path Bact 74: 419–438Google Scholar
  9. 9.
    Graham DI, Peterson A, McQueen A, Milne JA, Urich H (1975) Melanotic tumors (blue naevi) of spinal nerve roots. J Path 118: 83–89Google Scholar
  10. 10.
    Harkin JC, Reed RJ (1968) Tumors of the peripheral nervous system. Armed Forced Institute of Pathology, WashingtonGoogle Scholar
  11. 11.
    Hörstadius S (1950) The neural crest. Its properties and derivates in the light of experimental research. Geoffrey Gumberlege, Oxford University Press, London New York TorontoGoogle Scholar
  12. 12.
    Jimbow K, Szabo G, Fitzpatrick T (1973) Ultrastructure of giant pigment granules (macromelanosomes) in the cutaneous pigmented macules of neurofibromatosis. J Invest Derm 61: 300–309PubMedGoogle Scholar
  13. 13.
    Johnston MC (1966) A radioautographic study of the migration and fate of cranial neural crest cells in the chick embryo. Anat Rec 156: 143–156PubMedGoogle Scholar
  14. 14.
    Keegan HR, Mullan S (1962) Pigmented meningiomas: An unusual variant. Report of a case with review of the literature. J Neurosurg 19: 696–598PubMedGoogle Scholar
  15. 15.
    Limas C, Tio FO (1972) Meningeal melanocytoma (“melanotic meningeoma”). Its melanocytic origin as revealed by electron microscopy. Cancer 30: 1286–1294PubMedGoogle Scholar
  16. 16.
    Lowmann RM, Livolsi VA (1980) Pigmented (melanotic) schwannomas of the spinal canal. Cancer 46: 391–397PubMedGoogle Scholar
  17. 17.
    Mandybur TI (1974) Melanotic nerve sheath tumors. J Neurosurg 41: 187–192PubMedGoogle Scholar
  18. 18.
    Masson P (1951) My conception of cellular blue nevi. Cancer 4: 9–38PubMedGoogle Scholar
  19. 19.
    Meier RJ, Altermatt HJ, Musy JP, Gebbers J-O (1987) Melanotisches Schwannom. Der Pathologe 8: 282–290PubMedGoogle Scholar
  20. 20.
    Mennemeyer RP, Hallman KO, Hammar SPet al (1979) Melanotic schwannoma. Clinical and ultrastructural studies of three cases with evidence of intracellular melanin synthesis. Am J Surg Pathol 3: 3–10PubMedGoogle Scholar
  21. 21.
    Nakai T, Rappaport H (1963) A study of the histogenesis of experimental melanotic tumors resembling cellular blue nevi: the evidence in support of their neurogenic origin. Am J Path 43: 175–199PubMedGoogle Scholar
  22. 22.
    Pasquier B, Coudberg P, Pasquier D, Pahn MH, Aranuld JR (1978) Primary malignant melanoma of the cerebellum. Cancer 41: 344–351PubMedGoogle Scholar
  23. 23.
    Ray BS, Foot NC (1940) Primary melanotic tumor of the meninges: Resemblance to meningiomas. Report of two cases in which operation was performed. Arch Neurol 44: 104–117Google Scholar
  24. 24.
    Risteli J, Bechinger H, Engel J, Furthmayer H, Timpl R (1980) 7-S collagen: Characterization of an unusual basement membrane structure. Eur J Biochem 108: 239–250PubMedGoogle Scholar
  25. 25.
    Risteli L, Timpl R (1981) Isolation and characterization of pepsin fragment of laminin from human placental and renal basement membrane. Biochem J 193: 749–755PubMedGoogle Scholar
  26. 26.
    Russel DS, Rubinstein LJ (1977) Pathology of the tumors of the central nervous system. Edward Arnold Publishers LtdGoogle Scholar
  27. 27.
    Scott M, Ferrara VL, Peale AR (1971) Multiple melanotic meningiomas of the cervical cord. Case report. J Neurosurg 34: 555–559PubMedGoogle Scholar
  28. 28.
    Spence AM, Rubinstein LJ, Conley FKet al (1976) Studies on experimental malignant nerve sheath tumors maintained in tissue and organ culture systems: III. Melanin and melanogenesis in experimental neurogenic tumors: A reappraisal of the histogenesis of pigmented nerve sheath tumors. Acta Neuropathol 35: 27–45PubMedGoogle Scholar
  29. 29.
    Sternberger LA (1979) Immunocytochemistry, 2nd edn. Wiley, New YorkGoogle Scholar
  30. 30.
    Taxy JB, Battifora H, Trujillo Yet al (1981) Electron microscopy in the diagnosis of malignant schwannoma. Cancer 48: 1381–1397PubMedGoogle Scholar
  31. 31.
    Turnbull IM, Tom MI (1962) Pigmented meningioma. J Neurosurg 20: 76–80Google Scholar
  32. 32.
    Weiss SH, Langloss JM, Enzinger FM (1983) Value of S-100 protein of soft tissue tumors with particular reference to benign and malignant Schwann cell tumors. Lab Invest 49, 3: 299–308PubMedGoogle Scholar
  33. 33.
    Winston KR, Sotrel A, Schnitt SJ (1987) Meningeal melanocytoma. Case report and review of the clinical and histological features. J Neurosurg 66: 50–57PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1988

Authors and Affiliations

  • M. Röyttä
    • 1
  • J. Elfversson
    • 2
  • H. Kalimo
    • 1
  1. 1.Department of PathologyUniversity of TurkuFinland
  2. 2.Department of NeurosurgeryUniversity of GothenburgGotenburgSweden

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