神经系统黑色素瘤7例临床分析

目的 探讨神经系统黑色素瘤的诊断和治疗。方法 分析自1978年至2003年收治的7例神经系统黑色素瘤的临床表现、外科治疗和预后情况。结果 4例体表有黑色素痣，其余临床表现无特异性。6例患者均全部切除病灶。病理检查确诊转移性黑色素瘤6例，原发性黑色素瘤1例。对4例患者随访，3例患者术后3～11个月复发，其中1例行二次手术，4例均在术后3～14个月死亡。结论 神经系统黑色素瘤发病率低，术前误诊率高，治疗以手术切除为主，结合立体定向放射外科治疗。本病预后差。

Clinical manifestations and treatment of melanoma of central nervous system: analysis of 7 cases

Objective To investigate the diagnosis and treatment of melanoma of the central nervous system. Methods Seven patients with melanoma of the central nervous system were treated in our department between 1978 to 2003. Clinical manifestation, operative findings, histological diagnosis and prognosis were reviewed. Results Three of the seven patients manifested pigmented lesion of skin, others had non-specific clinical manifestations. Total removal of tumors was performed in six cases. Histological examination showed metastatic melanoma in six cases, primary melanoma in one case. Four cases were followed up. The tumor recurrence occurred in three cases 3 to 11 months after operation. Second operation was preformed in one case. Four cases died 3 to 14 months after operation. Conclusions Melanoma of the central nervous system is an extremely rare tumor and difficult to get correct preoperative diagnosis. Surgery combined with radiotherapy or stereotactic radiosurgery is recommended. The prognosis of this disease is very poor.