PMC6159240_01
Positron emission tomography/CT axial and coronal images demonstrate an 18F-fludeoxyglucose-avid mass in the right side of the neck with tubular extensions along the C3 and C4 nerves into the spinal cord, indicating perineural spread (arrows).
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Post-gadolinium T1 fat-suppressed axial and coronal MR images demonstrate an enhancing mass in the right side of the neck representing local melanoma recurrence, with perineural spread along the right C3 and C4 nerves and contiguous invasion into the spinal cord (arrows).
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Post- gadolinium T1 fat-suppressed images were particularly helpful in demonstrating the solid mass-like pattern of perineural nodular enhancement progressing retrogradely into the cervical cord substance (Figure 2).
Photomicrographs. (a) Papanicolaou stain (original magnification x40):fragments of tumour tissue containing spindle and epithelioid malignant cells with focal mitosis (arrow) morphologically consistent with melanoma. (b) Immunohistochemistry S100 (original magnification x40):tumour cells exhibit nuclear and cytoplasmic staining. (c) Haematoxylin and eosin stain of cell block:desmoplastic stroma infiltrated by a single malignant cell (arrow).
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On immunohistochemical analysis, the cells were positive for S100 protein (Figure 3).