Spinal Complications of Melanoma: A Case of Acute Paraplegia

Melanoma is an aggressive cancer with a high potential for metastasis, commonly spreading to organs such as the lungs, brain, liver, and bones. Bone metastases, particularly to the spine, are a frequent complication and can result in severe pain, spinal cord compression, and neurological deficits. Prompt diagnosis and treatment are critical, though managing spinal metastases from melanoma poses significant challenges. We present the case of a 41-year-old man with a history of malignant melanoma who developed acute paraplegia following a pathological fracture of the third thoracic vertebra. The patient reported rapidly worsening back pain and loss of motor function in the lower extremities. Magnetic resonance imaging revealed a metastatic lesion in the third thoracic vertebrae, causing spinal cord compression. An emergency open laminectomy with partial tumor resection and vertebroplasty was performed to decompress the spinal cord and stabilize the spine. Postoperative recovery was remarkable, with significant improvement in motor and sensory function within 48 hours. Histopathological and immunohistochemical analysis confirmed the metastatic melanoma diagnosis. This case highlights the challenges of diagnosing and managing acute paraplegia caused by spinal metastases in melanoma patients. Early recognition of symptoms and timely intervention are crucial to improving neurological outcomes.