A 55-year-old man presented for a routine preoperative chest X-ray in preparation for a knee replacement. Imaging revealed an extrapleural paraspinal mass in the region of T8. Fine needle aspiration of the mass was interpreted as melanoma. Neurologic examination was unremarkable. Total body skin examination failed to reveal any suspicious pigmented lesions. The mass was in close connection with the exiting T8 nerve root and somewhat adherent to the sympathetic chain. The mass was removed within an intact capsule. Immunohistochemical staining and electron microscopy of the resected specimen revealed a malignant melanotic schwannoma. The features of melanotic schwannoma, both benign and malignant variants, and their distinction from melanoma are discussed.
ASJC Scopus subject areas
- Pathology and Forensic Medicine
- Clinical Neurology