颅内黑色素瘤的诊断与治疗--附五例临床分析及文献复习

为讨论颅内黑色素瘤的临床表现、影像学特征及治疗方法 ,对本科近 13年来治疗的 5例颅内黑色素瘤进行回顾性分析。结果示颅内黑色素瘤的临床表现不具有特征性。影像学上CT表现为高密度或混杂密度 ,增强扫描呈不同程度强化。核磁共振检查 (MRI)表现为短T1短T2 信号 ,也可以因顺磁性黑色素含量不同和瘤内有无出血 ,表现为高、低或混杂信号 ,注射二乙胺五乙酸钆 (GD DTPA)后出现不同程度的强化。 5例患者中 ,3例手术全切 ,1例大部分切除 ,1例未手术。初步研究结果提示 ,颅内黑色素瘤的预后差 ,主张在手术基础上进行包括放疗及化疗的综合治疗

Diagnosis and treatment of intracranial malignant melanoma:clinical analysis of 5 cases and review of the literature

The objective of this paper was to explore the diagnosis and treatment of intracranial malignant melanoma. Five patients with intracranial malignant melanoma treated at Qilu hospital of Shangdong University from 1989-2002 were analysed retrospectively.There was no unique character in clinical manifestation of intracranial malignant melanoma. Five cases of melanoma were hyperintensity or mixed density on noncontrast CT scan and enhanced in varying degrees on contrast CT scan. The signal of melanoma was hyperintensity in T 1-wighted MRI and hypointensity in T 2-wighted MRI.In the Gd-DTPA enhanced T 1 weighted images, the tumors were enhanced in varying degrees.Three of five cases of melanomas were totally removed, one case subtotally, one case unsurgically. The prognosis of melanoma was poor. Comprehensive treatment including chemotherapy and radiotherapy on the basis of surgery should be suggested.