中枢神经系统恶性黑色素瘤的诊断与治疗

目的 探讨中枢神经系统恶性黑色素瘤的临床表现、影像学特点及诊治要点.方法 分析17例中枢神经系统恶性黑色素瘤的临床表现、影像学特点、诊治方法和疗效.结果 17例中13例位于幕上,幕下小脑半球3例,颈髓1例.其临床表现及体征无特异性,GT和MRI无法明确诊断.手术全切除12例,近全切除5例.病理检查均证实为恶性黑色素瘤.随访14例,均死于术后肿瘤复发,最短于术后1个月死亡,最长于术后14个月死亡,术后中位生存期6.5个月.结论 中枢神经系统恶性黑色素瘤发病率低,误诊率高,预后差,以手术切除为主,可辅以化疗、放疗等综合性治疗.

Dioagnosis and treatment of central nervous system malignant melanoma

Objective To investigate the diagnosis and treatment of CNS malignant melanoma.Methotis Seventeen patients with CNS malignant melanoma underwent surgery in our department between 1995-2008 were reviewed.Their clinical presentation,intraoperative findings,histological diagnosis,medical images and prognosis were studied.Results CNS malignant melanorna chould not be definitely diagnosed according to symptoms,signs and medical images.Thirteen lesions located in cerebral hemisphere,three in cerebellar hemisphere and one cervical cord.Total resection was achieved in 12 cases,and subtotal resection in 5 cases.Histological examination showed malignant melanoma in all 17 cases.Fourteen cases were followed up and all died due to tumor recurrence from one to fourteen months and the median survival time was 6.5 months.Couclusionn Malignant melarlonla is extrendy rare.Misdiagnosis rate is high and prognosis is poor.Combined therapy including chemotherapy and radiotherapy should be considered on the basis of operation.