[Melanotic schwannoma of C(III) spinal root]

We present a case report of the very rare tumor--melanotic schwannoma. Since its first description on 1932 only approximately 100 cases were reported in literature. Due to intensive pigmentation and many features that common for metastatic melanoma and melanotic schwannoma differentiation between these tumors is a challenging and important problem. 61-year-old male patient underwent surgical removal of pigmented extramedullary mass lesion at C2-C3 level. Melanotic schwannoma was diagnosed on the basis of morphological and immunohistochemical signs. Despite positive expression of so-called 'melanoma markers', (HMB-45, S-100, Melana A) cells of melanotic schwannoma also express type IV collagen and laminin which are not characteristic for melanoma. In addition, Ki-67 is very low in melanotic schwannoma, thus it confirms benign character of this tumor. Mentioned immunohistochemical profile allowed to diagnose melanotic schwannoma. It is distinctly clear that prognosis in melanotic schwannoma is incomparably better than in melanoma. Surgical removal is the best treatment option, and postoperative radiation therapy is not necessary as in melanoma.