Kharsa G, Molas G, Sterkers O, Henin D, Potet F
Service d'Anatomie, Hôpital Beaujon, Clichy la Garenne.
Ann Pathol. 1990;10(5-6):341-6.
A case of malignant melanoma discovered at the base of the skull is reported in a 52-year-old male. The patient with no previous significant history, complained of headaches. He developed progressive paralysis of the IX, X and XI left cranial nerves and a Claude-Bernard-Horner syndrome. The tumor, discovered at the nervous compartment of the jugular foramen was treated by surgery and radiotherapy. The patient died 27 months after surgery. The absence of other systemic localisations allows to consider this melanoma as primitive. The presence of spindle cell areas in the tumor may suggest the diagnosis of melanotic schwannoma. Immunohistochemistry is still disappointing because of the lack of specific markers. Our results, in agreement with those of the literature, emphasize the importance of the histopathological findings and the determining role of the electron microscopy in the diagnosis and the differential diagnosis of these two entities, whose nosological frontiers may, sometimes, be difficult to distinguish.
报告了一例52岁男性患者,其颅骨底部发现恶性黑色素瘤。该患者既往无重大病史,主诉头痛。他出现了左侧第IX、X和XI颅神经进行性麻痹以及Claude-Bernard-Horner综合征。在颈静脉孔神经腔发现的肿瘤接受了手术和放疗治疗。患者术后27个月死亡。未发现其他全身转移灶,因此可认为该黑色素瘤为原发性。肿瘤中存在梭形细胞区域可能提示黑色素性神经鞘瘤的诊断。由于缺乏特异性标志物,免疫组化结果仍不尽人意。我们的结果与文献一致,强调了组织病理学发现的重要性以及电子显微镜在这两种实体的诊断和鉴别诊断中的决定性作用,这两种实体的分类边界有时可能难以区分。