摘要
目的探讨中枢神经系统(CNS)原发恶性黑色素瘤的临床、影像学特点及治疗方式与预后。方法回顾性分析解放军总医院第一医学中心神经外科1999年1月—2019年1月,经显微手术治疗病理检查证实的17例CNS原发恶性黑色素瘤患者的临床资料。结果本组患者中男性13例,女性4例,年龄19~61岁。肿瘤位于颅内者15例、椎管内者2例;肿瘤最大直径为1.5~8.0 cm,平均4.5 cm。CT检查示12例患者(72%)的颅内病灶为等或高密度影;MRI检查示14例患者(82%)的病灶为短T1、短T2信号。手术肿瘤全切除者13例(76%),次全切除4例;病理检查均为恶性黑色素瘤。术后9例患者行放疗,1例患者行伽马刀治疗。16例患者死亡,中位生存期为18个月;1例患者正常生活。结论CNS原发恶性黑色素瘤的发病率低、误诊率高,加强对黑色素瘤特殊影像学特点的认识可提高术前诊断率;治疗方式以手术切除为主,结合放疗或立体定向放射治疗;但总体预后很差。
Objective To investigate the clinical and imaging features,treatment and prognosis of primary malignant melanoma in central nervous system(CNS).Methods The clinical data of 17 patients with CNS primary malignant melanoma confirmed by microsurgical treatment and pathological examination from January 1999 to January 2019 in the Department of Neurosurgery,The First Medical Center of The Chinese PLA General Hospital were analyzed retrospectively.Results There were 13 males and 4 females,aged from 19 to 61 years old.The largest diameter of the tumor ranged from 1.5 cm to 8.0 cm,with an average of 4.5 cm.CT examination showed that 12 patients(72%)had isodense or high-density lesions.MRI showed that 14 patients(82%)had short T1W and T2W signals.Of 17 patients,13(76%)underwent total resection and 4 underwent subtotal resection.Pathological examination confirmed as primary malignant melanoma.After operation,9 patients were treated with radiotherapy and 1 was treated with gamma knife.16 patients died with a median survival time of 18 months,and 1 patient had normal life.Conclusions The incidence rate of primary malignant melanoma in the central nervous system is low and the rate of misdiagnosis is high.Strengthening the understanding of the special imaging features of melanoma can improve the preoperative diagnostic rate.The main surgical treatment is surgical resection,combined with radiotherapy or stereotactic radiotherapy,but the overall prognosis is poor.
作者
陈利锋
韩丽娜
刘嘉霖
赵博
卜博
杨扬
CHEN Li-feng;HAN Li-na;ZHAO Bo;YANG Yang(Department of Neurosurgery,The First Medical Center of The Chinese PLA General Hospital,Beijing 100853,China;不详)
出处
《临床神经外科杂志》
CAS
2020年第5期528-532,共5页
Journal of Clinical Neurosurgery
基金
吴阶平医学基金会临床科研专项资助基金(320.6750.17297)。
关键词
黑色素瘤
中枢神经系统
诊断
治疗
malignant melanoma
central nervous system
diagnosis
treatment
