颅内原发性黑色素细胞瘤的临床特点
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摘要
目的探讨颅内原发性黑色素细胞瘤的临床特点。方法对本院1例颅内原发性黑色素细胞瘤患者及文献报道的15例患者的临床资料进行回顾性分析,通过查阅复习相关文献,对这一罕见疾病进行探讨。结果 16例患者症状表现为头痛10例(62. 5%),头晕5例(31. 3%),呕吐4例(25. 0%),视力下降3例(18. 8%),面部麻木2例(12. 5%),嗅觉障碍2例(12. 5%),复视2例(12. 5%),行走不稳2例(12. 5%),听力下降1例(6. 3%),癫痫1例(6. 3%)。CT多数表现为均匀高密度占位性病变,MRI表现为短T1、短T2信号。治疗以手术切除为主,术后病理证实为黑色素细胞瘤。结论 CNS原发性黑色素细胞瘤发病率低,儿童脑内发病更为罕见,其生物学行为相对良性,治疗提倡早期手术。
Objective To observe the clinical characteristics of intracranial primary melanocytoma. Methods The clinical data of 1 case of primary intracranial melanocytoma in our hospital and 15 cases reported in the literature were analyzed retrospectively. The rare disease was discussed by reviewing related literature. Results There were 16 patients in this group. Their symptoms were headache in 10 cases( 62. 5%),dizziness in 5 cases( 31. 3%),vomiting in 4 cases( 25. 0%),decreased visual acuity in 3 cases( 18. 8%),facial numbness in 2 cases( 12. 5%),olfactory disorder in 2 cases( 12. 5%),diplopia in 2 cases( 12. 5%),walking instability in 2 cases( 12. 5%),hearing loss in 1 case( 6. 3%),epilepsy in 1 case( 6. 3%). CT showed homogeneous and high density occupying lesion,and MRI showed short T_1,short T_2 signal. Surgical resection was the main treatment. Melanoma was confirmed by postoperative pathology. Conclusions The incidence of CNS primary melanocytoma is low. The incidence of children's brain is more rare. Its biological behavior is relatively benign. Treatment advocates early surgery.
Objective To observe the clinical characteristics of intracranial primary melanocytoma. Methods The clinical data of 1 case of primary intracranial melanocytoma in our hospital and 15 cases reported in the literature were analyzed retrospectively. The rare disease was discussed by reviewing related literature. Results There were 16 patients in this group. Their symptoms were headache in 10 cases( 62. 5%),dizziness in 5 cases( 31. 3%),vomiting in 4 cases( 25. 0%),decreased visual acuity in 3 cases( 18. 8%),facial numbness in 2 cases( 12. 5%),olfactory disorder in 2 cases( 12. 5%),diplopia in 2 cases( 12. 5%),walking instability in 2 cases( 12. 5%),hearing loss in 1 case( 6. 3%),epilepsy in 1 case( 6. 3%). CT showed homogeneous and high density occupying lesion,and MRI showed short T_1,short T_2 signal. Surgical resection was the main treatment. Melanoma was confirmed by postoperative pathology. Conclusions The incidence of CNS primary melanocytoma is low. The incidence of children's brain is more rare. Its biological behavior is relatively benign. Treatment advocates early surgery.
引文
[1]张剑宁,章翔,李兵,等.颅内脑膜黑色素细胞瘤的临床病理特征与诊治[J].第四军医大学学报,2003,24:668.
[2]张永海,李君召,张显峰.颅内原发性黑色素细胞瘤1例[J].中国医学影像技术,2011,27:1099.
[3]戚荣丰,张宗军,卢光明,等.颅内原发性黑色素细胞瘤一例[J].中华放射学杂志,2010,44:105.
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[10]沈袆,徐新运,陈锦.中枢神经黑色素细胞瘤的临床病理特征及MRI分析[J].现代肿瘤医学,2016,24:3049.
[11]崔华娟,王卓才,王炜,等.中枢神经系统脑脊膜黑色素细胞瘤三例及文献复习[J].中华神经外科杂志,2013,29:58.
[12]Limas C,Tio FO.Meningeal melanocytoma(‘melanotic meningioma’).Its melanocytic origin as revealed by electron microscopy[J].Cancer,1972,30:1286.
[13]周渊,王汉东,马驰原,等.中枢神经系统原发性黑色素细胞瘤的治疗体会[J].医学研究生学报,2014,27:952.
[14]Wang J,Gun ZZ,Wang YJ,et al.Microsurgery for the treatment ofprimary malignant intracranial melanoma:a surgical series andliterature review[J].Eur J Surg Oncol,2014,40:1062.
[15]Rahimi-Movaghar V,Karimi M.Meningeal melanocytoma of the brain and oculodermal melanocytosis(nevus of Ota):case report and literature review[J].Surg Neurol,2003,59:200.
[16]陈菁,邱士军,熊炜烽,等.颅内黑色素瘤的CT及MRI诊断[J].临床放射学杂志,2011,30:1572.
[17]赵燕,李南云,张继,等.多次多点发生的脑脊膜黑色素细胞瘤一例[J].中华病理学杂志,2014,43:699.
[18]吴春,王海,李南云,等.中枢神经系统黑色素细胞瘤10例临床病理与超微结构分析[J].诊断病理学杂志,2010,17:245.
[19]虞晨,陈维涛,赵寅涛,等.原发性脊膜黑色素细胞瘤一例并文献复习[J].临床神经外科杂志,2016,13:186.
[20]Lin B,Yang H,Qu L,et al.Primary meningeal melanocytoma of the anterior cranial fossa:a case report and review of the literature[J].World J Surg Oncol,2012,10:135.
[21]Rades D,Schild SE.Dose-response relationship for fractionated irradiation in the treatment of spinal meningeal melanocytomas:a review of the literature[J].J Neuro-oncol,2006,77:311.
[2]张永海,李君召,张显峰.颅内原发性黑色素细胞瘤1例[J].中国医学影像技术,2011,27:1099.
[3]戚荣丰,张宗军,卢光明,等.颅内原发性黑色素细胞瘤一例[J].中华放射学杂志,2010,44:105.
[4]吴迪,王银萍,金美善,等.脑膜黑色素细胞瘤1例[J].诊断病理学杂志,2012,19:74.
[5]罗永春,秦家振,赵春平,等.脑膜黑色素细胞瘤1例报告并文献复习[J].中国误诊学杂志,2007,7:7230.
[6]张璋,魏兵,步宏,等.脑膜黑色素细胞瘤一例[J].中华神经外科杂志,2003,19:479.
[7]孙亚非,张海峰,王全红.脑膜黑色素细胞瘤一例并文献复习[J].中国药物与临床,2004,4:465.
[8]韩丽霞,安凤玲.脑膜原发黑色素细胞瘤1例并文献复习[J].中国保健营养,2012,12:5094.
[9]巴晓群,任国平.原发性中枢神经系统黑色素细胞瘤2例临床病理分析[J].中国临床神经科学,2015,23:428.
[10]沈袆,徐新运,陈锦.中枢神经黑色素细胞瘤的临床病理特征及MRI分析[J].现代肿瘤医学,2016,24:3049.
[11]崔华娟,王卓才,王炜,等.中枢神经系统脑脊膜黑色素细胞瘤三例及文献复习[J].中华神经外科杂志,2013,29:58.
[12]Limas C,Tio FO.Meningeal melanocytoma(‘melanotic meningioma’).Its melanocytic origin as revealed by electron microscopy[J].Cancer,1972,30:1286.
[13]周渊,王汉东,马驰原,等.中枢神经系统原发性黑色素细胞瘤的治疗体会[J].医学研究生学报,2014,27:952.
[14]Wang J,Gun ZZ,Wang YJ,et al.Microsurgery for the treatment ofprimary malignant intracranial melanoma:a surgical series andliterature review[J].Eur J Surg Oncol,2014,40:1062.
[15]Rahimi-Movaghar V,Karimi M.Meningeal melanocytoma of the brain and oculodermal melanocytosis(nevus of Ota):case report and literature review[J].Surg Neurol,2003,59:200.
[16]陈菁,邱士军,熊炜烽,等.颅内黑色素瘤的CT及MRI诊断[J].临床放射学杂志,2011,30:1572.
[17]赵燕,李南云,张继,等.多次多点发生的脑脊膜黑色素细胞瘤一例[J].中华病理学杂志,2014,43:699.
[18]吴春,王海,李南云,等.中枢神经系统黑色素细胞瘤10例临床病理与超微结构分析[J].诊断病理学杂志,2010,17:245.
[19]虞晨,陈维涛,赵寅涛,等.原发性脊膜黑色素细胞瘤一例并文献复习[J].临床神经外科杂志,2016,13:186.
[20]Lin B,Yang H,Qu L,et al.Primary meningeal melanocytoma of the anterior cranial fossa:a case report and review of the literature[J].World J Surg Oncol,2012,10:135.
[21]Rades D,Schild SE.Dose-response relationship for fractionated irradiation in the treatment of spinal meningeal melanocytomas:a review of the literature[J].J Neuro-oncol,2006,77:311.