中枢神经系统黑色素瘤15例临床分析

目的 探讨中枢神经系统黑色素瘤的诊治方法。方法 分析自1996年12月至2003年2月收治的15例中枢神经系统黑色素瘤患者的临床表现、外科治疗和预后情况。结果 15例黑色素瘤患者中发生于颅内者12例,椎管内者3例。临床表现无特征性。手术全切除5例,大部切除10例。病理检查黑色素瘤10例,脑脊膜黑色素细胞瘤4例,无色素性黑色素瘤1例。10例获得随访,9例死亡,1例恢复正常生活。结论 中枢神经系统黑色素瘤发病率低,误诊率较高,治疗以手术切除为主,结合放疗或γ刀治疗。本病预后差。

Clinical manifestations and treatment of melanoma of the central nervous system: analysis of 15 cases

OBJECTIVE: To investigate the diagnosis and treatment of melanomas of the central nervous system. METHODS: The clinical data, including presentation, treatment, operative finding, histological diagnosis and prognosis of 15 patients with melanomas of central nervous system who underwent surgery 1996 - 2003 were reviewed. RESULTS: There were 12 cases of intracranial melanoma and 3 cases of spinal cord melanomas. No distinctive symptoms occurred in these patients. Total resection was achieved in 5 cases, and subtotal resection in 10 cases. Histological examination showed melanoma in 10 cases, meningeal melanocytoma in 4 cases, and amelanotic melanoma in 1 case. Ten cases were followed up for 3 months to 9 years. Among the 10 cases only 1 survived. CONCLUSION: Melanoma of the central nervous system is an extremely rare tumor and difficult to get correct preoperative diagnosis. Microsurgery combined with radiotherapy or gamma-knife therapy is recommended. The prognosis is very poor.