CASE REPORT article
Front. Med.
Sec. Hematology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1601774
This article is part of the Research TopicEndothelium, Innate Immunity and Coagulation in Hematological DisordersView all 21 articles
Malignant melanoma bone marrow infiltration induced coagulation dysfunction and spinal epidural haematoma with paraplegia: a case report and literature review
Provisionally accepted
- 1Department of Spine Surgery, Shenzhen Hospital, Peking University, Shenzhen, China
- 2Department of Spine Surgery, Shenzhen Xinhua Hospital, Shenzhen, China
- 3Department of Pathology, Shenzhen Hospital, Peking University, Shenzhen, China
- 4Shenzhen Hospital, Peking University, Shenzhen, China
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Word count: 252 Malignant melanoma bone marrow infiltration induced coagulation dysfunction and spinal epidural haematoma with paraplegia is extremely rare. It typically presents as anemia, coagulation dysfunction or disseminated intravascular coagulation, immune thrombocytopenia. In severe cases, it can lead to spinal epidural hematoma, compressing the spinal cord and nerve roots, resulting in motor and sensory dysfunction, and even paraplegia. Due to the rarity and complexity of this condition, it is prone to misdiagnosis or delayed diagnosis, ultimately leading to a poor prognosis. This paper reports the case of a 14-year-old female who was urgently admitted to the emergency department with low back pain for one month, accompanied by systemic mucous membranes bleeding and ecchymosis for half a month, numbness and incomplete paralysis in both lower limbs for three days. Laboratory tests indicated pancytopenia and abnormal coagulation function. Magnetic resonance imaging: T11-L1 epidural irregular abnormal signals in the spinal canal, with a range of about 16mm×17mm×65mm. Further physical examination revealed that a large, cauliflower-like black mole on the right scalp, which had been present since childhood and had recurrently ulcerated without healing. Bone marrow aspiration biopsy confirmed the diagnosis of malignant melanoma with bone marrow infiltration, leading to coagulation dysfunction and SEH with paraplegia. However, despite two months of aggressive symptomatic and supportive treatment, the child ultimately succumbed to malignant melanoma forever. This report shares our experience with the diagnosis and treatment of this case, highlighting the necessity of thoroughly reassess the medical history and conduct a detailed physical examination.
Keywords: Bone marrow infiltration, Coagulation dysfunction, case report, malignant melanoma, Paraplegia, Spinal epidural haematoma
Received: 28 Mar 2025; Accepted: 22 Sep 2025.
Copyright: © 2025 Liu, Zhang, Shi, Guo, Yin, Xu, Liu and Min. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Shaoxiong Min, msx1776@163.com
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