颅内原发性黑色素瘤的诊断和治疗  

Diagnosis and treatment for primary intracranial melanoma

作　　者：胡文忠[1] 曾现伟[2] 刘红林[1] 陈小兵[1] 段国庆[1] 

机构地区：[1]河南大学淮河医院神经外科,开封475000 [2]潍坊医学院附属医院神经外科

出　　处：《中华神经外科杂志》2011年第7期693-696,共4页Chinese Journal of Neurosurgery

摘　　要：目的 探讨颅内原发性黑色素瘤的临床特点,提高对此病的诊断治疗水平.方法 回顾性分析自2000年1月至2009年12月收治的8例颅内原发性黑色素瘤患者,男6例,女2例;年龄24～68岁;病灶均为单发,位于额叶4例,顶叶1例,枕叶1例,镰旁1例,小脑脑桥角1例.8例患者均行开颅手术,6例达全切;2例行次全切除＋辅助伽玛刀治疗.结果 病理结果均为原发性黑色素瘤;术后7例患者获随访,随访时间10-82个月.死亡2例,分别于术后14个月及21个月死于肿瘤复发;1例于术后6个月复发,再次行手术全切,术后化疗,术后6个月MRI未见复发征象;1例于术后9个月复发,再次行手术全切,术后化疗,术后6个月MRI示肿瘤再次复发;余3例未见复发征象.结论 颅内原发性黑色素瘤发病率低,误诊率较高,治疗以手术切除为主,不全切除者应辅助伽玛刀治疗,复发者可行辅助化疗,延缓复发时间,改善患者预后.Objective To investigate the clinical features, imaging findings and treatment for primary intracranial melanoma. Method The clinical data including presentation, imaging, treatment and prognosis of 8 patients with primary intracranial melanoma underwent surgery were reviewed during the past ten years. The patients included six males and two females and the age range was from 24 to 68 years. Four lesions were located in frontal lobe and the other four were located in parietal lobe, Occipital lobe, parafalcine and cerebellopontine angle respectively. Total removal was achieved in 6 patients and subtotal resection in 2 who had adjuvant radiosurgery. Results Histological examination showed that all cases were melanoma. Follow - up study was gained in seven cases and the follow - up duration was from 10 to 82 months. Two patients died from recurrence at postoperative 14th months and 21st months respectively. One case had tumor recurrence 6 months after surgery and another operation was performed to gain total removal. Adjuvant chemotherapy was performed and there was no recurrence found in MRI 6 months after the surgery. One patient had tumor recurrence 9 months after surgery and another operation was performed to gain total removal. Adjuvant chemotherapy was performed and follow - up MRI showed recurrence 6 months after surgery. There was no recurrence in the other 3 cases. Conclusions Primary intracranial melanoma is an extremely rare tumor and difficult to get correct preoperative diagnosis. Surgical removal of tumor plays an important role in its treatment. Part of patients could gain profits from radiotherapy and chemotherapy. The prognosis is very poor.

关 键 词：黑色素瘤 中枢神经系统肿瘤 诊断 治疗 

分 类 号：R739.41[医药卫生—肿瘤]