The Spine Journal 14 (2014) 716–717
Black hole in the spine A 35-year-old woman was admitted to our center with lower back pain 12 months after the delivery of a healthy girl. During the ninth week of her gestation, a malignant melanoma in the right groin had been diagnosed (Beslow 2.1 mm, Clark level IV, pT3a, Nx, Mx, mitotic index 1/qmm). Because of the patient’s pregnancy, tumor staging by computed tomography (CT) was impossible; however, magnetic resonance imaging showed negative results. The patient could not undergo adjuvant immunotherapy because of her pregnancy. Six months after her child was born, a swollen lymph node in the right groin was detected, with histopathologic-proven metastasis of malignant melanoma (pN1 [1/14]), which was followed by chemotherapy. Again, 6 months later, in a follow-up CT scan, an osteolytic lesion in the third lumbar vertebral body (Fig. 1) was detected. Surgical specimen obtained from an en-bloc resection of the lumbar vertebral body showed black-colored bone mass (Fig. 2) corresponding with the osteolysis (Fig. 3), which was histologically proven metastasis of malignant melanoma (Fig. 4).
Fig. 1. Detail of a sagittal computed tomography scan of the lumbar spine. 1529-9430/$ - see front matter Ó 2014 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.spinee.2013.10.034
Fig. 2. Macroscopic view of the third lumbar vertebrae.
Josephine Berger, MDa Jozef Zustin, MDb a Department of Trauma Hand and Reconstructive Surgery University Hospital Hamburg Eppendorf Martinistraße 52, 20246 Hamburg Germany
Fig. 3. Osteolysis of the third lumbar vertebra.
J. Berger and J. Zustin / The Spine Journal 14 (2014) 716–717
717 b
Institute of Pathology University Hospital Hamburg Eppendorf Martinistraße 52, 20246 Hamburg Germany FDA device/drug status: Not applicable. Author disclosures: JB: Nothing to disclose. JZ: Nothing to disclose.
Fig. 4. Microscopic view of the third lumbar vertebra with Prussian blue stain.
Black hole in the spine A 35-year-old woman was admitted to our center with lower back pain 12 months after the delivery of a healthy girl. During the ninth week of her gestation, a malignant melanoma in the right groin had been diagnosed (Beslow 2.1 mm, Clark level IV, pT3a, Nx, Mx, mitotic index 1/qmm). Because of the patient’s pregnancy, tumor staging by computed tomography (CT) was impossible; however, magnetic resonance imaging showed negative results. The patient could not undergo adjuvant immunotherapy because of her pregnancy. Six months after her child was born, a swollen lymph node in the right groin was detected, with histopathologic-proven metastasis of malignant melanoma (pN1 [1/14]), which was followed by chemotherapy. Again, 6 months later, in a follow-up CT scan, an osteolytic lesion in the third lumbar vertebral body (Fig. 1) was detected. Surgical specimen obtained from an en-bloc resection of the lumbar vertebral body showed black-colored bone mass (Fig. 2) corresponding with the osteolysis (Fig. 3), which was histologically proven metastasis of malignant melanoma (Fig. 4).
Fig. 1. Detail of a sagittal computed tomography scan of the lumbar spine. 1529-9430/$ - see front matter Ó 2014 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.spinee.2013.10.034
Fig. 2. Macroscopic view of the third lumbar vertebrae.
Josephine Berger, MDa Jozef Zustin, MDb a Department of Trauma Hand and Reconstructive Surgery University Hospital Hamburg Eppendorf Martinistraße 52, 20246 Hamburg Germany
Fig. 3. Osteolysis of the third lumbar vertebra.
J. Berger and J. Zustin / The Spine Journal 14 (2014) 716–717
717 b
Institute of Pathology University Hospital Hamburg Eppendorf Martinistraße 52, 20246 Hamburg Germany FDA device/drug status: Not applicable. Author disclosures: JB: Nothing to disclose. JZ: Nothing to disclose.
Fig. 4. Microscopic view of the third lumbar vertebra with Prussian blue stain.
