# Surgical Management of Primary Thoracic Epidural Melanoma

## TL;DR

This paper presents a rare case of using robotic-assisted surgery to treat a primary thoracic epidural melanoma, showing improved patient outcomes.

## Contribution

The first reported use of robotic-assisted navigation with CF/PEEK screws for thoracic epidural melanoma surgery.

## Key findings

- The patient experienced improved neurological conditions after partial tumor resection.
- Postoperative imaging confirmed successful spinal stabilization.
- No adverse events were observed following stereotactic body radiation therapy.

## Abstract

In this study, we reported one of the first cases where a rare robotic-assisted platform with neuronavigation technology and carbon-fiber-polyetheretherketone (CF/PEEK) screws is employed to surgically treat multilevel thoracic primary spinal epidural melanoma. A 67-year-old male presented with left upper thoracic pain. His magnetic resonance imaging (MRI) of the thoracic spine revealed a dumbbell-shaped left epidural mass at the T2-3 level. Partial resection was performed due to tumor growth into the vertebral bodies and patient discretion for minimal surgery. The patient’s neurological conditions improved postoperatively, with reduced reported symptoms of pain and numbness. Postoperative imaging showed evidence of appropriate spinal stabilization. Patient underwent stereotactic body radiation therapy (SBRT), and no adverse events were reported. This case reflects one of the first examples of treating thoracic epidural melanoma with the use of robotic-assisted navigation. Further prospective studies are needed to determine the efficacy of robot-assisted navigation for patients with primary spinal malignant melanoma which may open the possibility of surgery to once presumed non-operative patients.