摘要
目的探讨中枢神经系统黑色素肿瘤的临床特征、治疗策略及预后。方法回顾性分析2006年7月至2012年6月北京天坛医院收治经组织病理学证实的24例中枢神经系统黑色素肿瘤临床资料，并进行随访。根据Willis诊断观点，本组原发性黑色素细胞肿瘤8例，转移性恶性黑色素瘤16例。20例术前进行了MRI检查，其中15例表现为短T1短T2信号。所有患者均接受手术治疗。结果肿瘤全切除11例，近全切除9例、大部切除4例。原发性黑色素细胞肿瘤8例均获得随访，其中2例死亡，术后分别存活15及40个月，其余6例患者术后13—56个月，目前仍存活。转移性黑色素瘤14例获得随访，8例死亡，中位生存时间4．5个月。6例术后1～7个月，目前仍存活。术后免疫组化检测结果为HMB-45阳性比例9／10，S-100阳性比例9／11，Vimentin阳性比例8／11。结论中枢神经系统黑色素肿瘤发病率低，具有特征性影像学表现，免疫组化染色有利于病理诊断，治疗以手术切除为主，临床分型对判断预后有重要意义。
Objective To explore the clinical manifestations, diagnosis, treatment and prognostic features of melanocytic neoplasms of central nervous system （CNS）. Methods A total of 24 patients with melanocytic neoplasms of CNS underwent surgery and were confirmed pathologically our hospital during 2006-2012. Their clinical data were collected. There were primitive melanocytic neoplasms （ n = 8 ） and metastatic melanoma （ n = 16） according to the diagnostic criteria of Willis. The scans of magnetic resonance imaging （MRI） showed hyperintensity on T1 weighted image （n = 15 ） and hypointensity on T2 weighted image （ n = 20）. Results The outcomes were total resection （ n = 11 ）, subtotal resection （ n = 9） and partial resection （n = 4）. All 8 primitive melanocytic neoplasms were followed up. Among them, 2 cases died postoperatively at 15 and 40 months respectively. The remaining 6 cases survived 13 -56 months after craniotomy. And 14/16 patients of metastatic melanoma were followed up, 8 cases died and the mean survival period was 4. 5 months. The remaining 6 cases survived 1 - 7 months after craniotomy. Immunohistochemical staining demonstrated that the positive rate of HMB-45 was 9/10, S-100 9/11 and Vimentin 8/11. Conclusion Melanocytic neoplasms of CNS are rare lesions with characteristic MRI features. Immunohistochemical staining helps to reach a definite pathological diagnosis. Surgical excision is recommended. Differentiation of orimarv and metastatic neoolasm is critical for nroanostic evaluations.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第1期34-36,共3页
National Medical Journal of China
关键词
中枢神经系统肿瘤
黑色素瘤
临床特征
Central nervous system neoplasms
Melanoma
Clinical features
