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.