Spinal extradural angiolipomas (SEALs) are extremely extraordinary benign extradural lesions. They are infrequently encountered in normal clinical practice although several authors have report single cases or case series. We present two cases of SEAL which we successfully surgical resected with no further neurological deficits. Our cases comprise of a male and a female with ages ranging from 30 to 60 years. Their principal presenting complains were numbness and pain at the lower extremity with associated fecal and urinary incontinence. In all our cases, MRI revealed extradural spinal lesions that exerted compressive effect on the spinal cord. The male patient had an infiltrating type while the female had non-infiltrating type. We attained total resection in both cases without any further neurological complication. The diagnosis of SEALs initially can be challenging radiologically since they may mimic other spinal lesions. The gold standard treatment modality should always be surgery although total resection may not be achievable in some cases.

BACKGROUND: Primary cervical melanoma is rare; this is especially true of extradural melanoma arising in the nerve root. Characterizing these cases can provide a basis for improved melanoma management.
METHODS: A 42-year-old female patient with numbness and pain in the right shoulder and arm persisting for 5 years was admitted. Preoperative magnetic resonance imaging revealed an epidural ladle-shaped mass shape beyond the C7-T1 intervertebral foramen that resembled a nerve sheath tumor. Histopathologic analysis following complete resection confirmed the lesion as malignant melanoma. Radiotherapy and temozolomide and cisplatin chemotherapy were administered in an accompanying hospital with regular follow-ups at our institution. After 2 months of postoperative adjuvant therapy, hepatic metastatic lesions developed. The chemotherapy regimen was changed to carboplatin, nab-paclitaxel, and recombinant human endostatin injections for a 6-month period. Follow-up 8 months after chemotherapy (16 months post surgery) indicated a good prognosis.
CONCLUSIONS: In the past 10 years only 1 case of primary extradural spinal melanoma in cervical intervertebral foramen has been described, with no reported cases of hepatic metastasis. As radiographic results are not unequivocal, a diagnosis of spinal melanoma must be based on postoperative histologic confirmation. However, to date there is no standard postoperative adjuvant therapy for these patients. The chemotherapy regimen described in this report has broader implications for melanoma treatment.

OBJECTIVE: Spinal extradural meningeal cyst (EMC) aetiology remains unclear. Based on our in-depth analysis of EMC clinical characters, we propose the alternative term \'dural dissection cyst\' (DDC), which is more consistent with its aetiology and pathological manifestations.
METHODS: We examined the clinical, imaging and operative findings of four patients with spinal EMC (type I A) and analysed the aetiology and treatment of the cyst.
RESULTS: Spinal DDC was observed between T10 and L3 in our series. Patients presented with low back pain, lower extremity numbness and weakness, and segmental muscle atrophy. Small clefts were found on the inner wall of all cysts. Microscopic suture of the cleft successfully improved patient\'s symptoms and neurological deficits.
CONCLUSIONS: Spinal EMC (type I A) is characterized by dural dissection, so the term DDC can best reflect its aetiology. Because it is a dissection cyst, the most reasonable treatment is to suture the fistula.

Metastatic melanoma of the spine usually occurs as vertebral metastatic melanoma or intramedullary spinal cord metastatic melanoma. The present study reports a case of easily misdiagnosed delayed metastatic intraspinal extradural melanoma of the lumbar spine. A 67-year-old female patient presented with lower back pain accompanied by progressive intermittent claudication. Magnetic resonance imaging (MRI) suggested compression of the lumbar spinal cord caused by an extradural mass. The mass showed T2-hypointensity, T1-hypointensity and slight enhancement following a gadolinium-contrast injection. The patient had been diagnosed with a vulvar melanoma 13 years previously and had also undergone a resection of this tumor. A current diagnosis of a lumbar stenosis resulting from hypertrophy of the ligamentum flavum was suspected. However during corrective surgery, a dark gray solid mass was observed. An L3 laminectomy and removal of the tumor was performed. The tumor was confirmed to be a malignant melanoma by histopathological investigation. The patient was treated with radiotherapy and immunotherapy. At the final 13-month follow-up, the patient showed no signs of recurrence. It may be concluded that an early diagnosis of metastatic melanoma was prevented by delayed metastasis, the location of the mass and its unusual appearance in MRI scans. In such cases, early surgical removal and an appropriate comprehensive treatment are critical for patient survival. These observations suggest that caution should be used in the diagnosis of similar cases.