Chiarion-Sileni Vanna, Murr Rita, Pigozzo Jacopo, Sarti Samanta, Tomassi Ottaviano, Romanini Antonella
Oncology Department, Busonera Hospital, Padova, Italy.
Forum (Genova). 2003;13(2):170-82; quiz 190.
Metastatic spread of tumour cells detached from melanoma into the central nervous system (CNS) occurs haematogenously since lymphatic drainage is absent in the brain. CNS metastases occur in 10 to 40% of melanoma patients in clinical studies and up to 90% in autopsy studies. Headache is the most common presenting symptom, but brain metastases should be suspected in all melanoma patients with new neurologic findings. Magnetic resonance imaging is the best diagnostic technique for detecting CNS metastases. Median survival of melanoma patients with CNS metastases ranges between 2 and 8 months. The optimal treatment of melanoma patients with CNS metastases depends on the objective situation, often surgery, radiosurgery, whole brain radiotherapy and chemotherapy are used in combination to obtain longer remissions and optimal symptom relieve.
从黑色素瘤脱离的肿瘤细胞经血行转移至中枢神经系统（CNS），因为脑部不存在淋巴引流。临床研究中，10%至40%的黑色素瘤患者会发生CNS转移，尸检研究中这一比例高达90%。头痛是最常见的首发症状，但所有有新神经学表现的黑色素瘤患者都应怀疑有脑转移。磁共振成像（MRI）是检测CNS转移的最佳诊断技术。发生CNS转移的黑色素瘤患者的中位生存期在2至8个月之间。黑色素瘤CNS转移患者的最佳治疗取决于实际情况，通常联合使用手术、立体定向放射外科、全脑放疗和化疗以获得更长的缓解期和最佳的症状缓解。
