右侧小脑半球罕见囊实性脑膜黑色素瘤1例并文献复习  

Rare cystic solid meningeal melanoma in the right cerebellar hemisphere:report of one case and literature review

作　　者：盛成俊 赵小玉 沈宇晟 李彦东 吴徐超 曾加 吴昊[2] 麦麦提力·米吉提[2] 更·党木仁加甫 朱国华[2] SHENG Chengjun;ZHAO Xiaoyu;SHEN Yusheng;LI Yandong;WU Xuchao;ZENG Jia;WU Hao;MAIMAITILI Mijiti;GENG Dangmurenjiafu;ZHU Guohua(Department of Neurosurgery,Nanyang Central Hospital,Nanyang 422000,China)

机构地区：[1]南阳市中心医院神经外科,南阳422000 [2]新疆医科大学第一附属医院神经外科

出　　处：《临床神经外科杂志》2024年第6期717-720,共4页Journal of Clinical Neurosurgery

基　　金：自治区研究生创新项目(XJ2022G172)。

摘　　要：目的 探讨脑膜黑色素瘤的临床特点、诊断及治疗方法。方法 回顾性分析新疆医科大学第一附属医院神经外科收治的1例右侧小脑半球脑膜黑色素瘤患者的临床资料,并结合相关文献进行回顾。手术采用旁正中入路,显微镜下右侧小脑半球肿瘤切除术,术后给予放疗辅助治疗。结果 患者因头痛、头晕伴步态不稳20余天入院。头颅核磁示右侧小脑半球可见一囊实性占位。术后病理结果显示右侧小脑半球脑膜黑色素瘤。术后给予辅助放疗治疗,出院卡氏功能状态(KPS)评分90分,随访患者术后9个月死亡。结论 囊实性脑膜黑色素瘤是颅内罕见的恶性肿瘤,术前诊断困难,需结合多种诊疗手段,手术以全切为目标,肿瘤预后差,免疫治疗联合基因靶向药物治疗等新辅助治疗可改善预后。Objective To investigate the clinical characteristics,diagnosis and treatment of eningeal melanoma.Methods The clinical data of a patient with right cerebellar hemispheric meningeal melanoma admitted to the Department of Neurosurgery,the First Affiliated Hospital of Xinjiang Medical University were analyzed retrospectively.The related literature were reviewed.The surgery was performed through a paramedian approach with microscopic resection of the right cerebellar hemisphere tumor,and postoperative radiotherapy was given as adjuvant treatment.Results The patient was admitted to the hospital with headache and dizziness with unsteadiness in walking for more than 20 days.The cranial magnetic resonance imaging showed a cystic solid occupancy in the right cerebellar hemisphere.Postoperative pathological findings showed a right cerebellar hemisphere meningeal melanoma.Postoperative adjuvant radiotherapy was given,and discharge Karnofsky performance scale(KPS)score was 90.The patient died 9 months after follow-up.Conclusions Cystic meningeal melanoma is a rare malignant intracranial tumor,which is difficult to diagnose preoperatively and requires a combination of multiple diagnostic and therapeutic approaches.Surgery is aimed at total excision and the tumor has a poor prognosis,and neoadjuvant therapy such as immunotherapy combined with gene targeted drug therapy can improve the prognosis.

关 键 词：囊实性脑膜黑色素瘤 免疫靶向疗法 基因靶向疗法 

分 类 号：R739.41[医药卫生—肿瘤] R651[医药卫生—临床医学]