Intratumoural hydrogen peroxide injection during resection of metastatic vertebral melanoma. Technical note

It is well recognized that the surgical removal of vertebral metastases of several malignant tumours often causes extensive bleeding, increasing the difficulties for surgeons and the risks for patients. Among the different subtypes of malignancies involved, melanoma has an extensive vascularity, and its resection is frequently challenging because of a continuous and annoying bleeding. A 55-year-old patient with a history of treated melanoma was operated on urgently for a severe T10–11 spinal cord compression by a huge metastasis involving the peridural space and the vertebral bone. During the resection, we injected, in successive stages, a total of 5 ml of 3% hydrogen peroxide (H₂O₂) solution, with good control of tumour bleeding. The patient had no problems related to the procedure, and 6 months after the surgery he is able to perform sustained walking. The aim of this manuscript is to report a safe, simple, effective, inexpensive and readily available technique for intraoperative haemostasis that could allow the control of tumour bleeding and facilitate its excision.