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[原发性髓内黑色素瘤:病例报告及文献综述]

[Primary intramedullary melanoma: Case report and literature review].

作者信息

Narváez-Martínez Yislenz, de la Ossa Napoleón, López-Martos Raquel, Cohn-Reinoso Carlos, Castellví-Juan Marina, Martin-Ferrer Secundino

机构信息

Servicio de Neurocirugía, Hospital Universitari de Girona Dr. Josep Trueta, Girona, España.

Servicio de Patología, Hospital Universitari de Girona Dr. Josep Trueta, Girona, España.

出版信息

Neurocirugia (Astur). 2017 Jul-Aug;28(4):190-196. doi: 10.1016/j.neucir.2017.01.003. Epub 2017 Feb 23.

Abstract

A dark pigmented intramedullary mass is very rarely encountered in daily practice, and poses a diagnostic challenge. Several entities have to be considered, including melanin-containing tumours (melanotic ependymoma and melanotic schwannoma) and melanocyte-containing tumours (melanocytoma, primary melanoma and melanoma metastases). The case is presented of a 47 year-old male with a pigmented intramedullary tumour located at T7-T8 level. Magnetic resonance images (MRI) revealed a tumour with hyperintensity on T1 and hypointensity on T2. The tumour was resected partially and treated with adjuvant radiotherapy. The diagnosis of primary intramedullary melanoma (PIM) was established based on histology and the absence of other lesions outside of the CNS. A literature review is presented on the other 26 PIM cases reported. PIM are extremely rare tumours, but are the most frequent cause of pigmented intramedullary tumour. Complete surgical resection is the treatment of choice whenever possible, followed by radiotherapy.

摘要

在日常临床实践中,深色色素沉着的髓内肿块极为罕见,且具有诊断挑战性。必须考虑多种病变,包括含黑色素的肿瘤(黑色素性室管膜瘤和黑色素性神经鞘瘤)以及含黑素细胞的肿瘤(黑素细胞瘤、原发性黑色素瘤和黑色素瘤转移瘤)。本文报告了一例47岁男性患者,其髓内肿瘤位于T7 - T8水平,呈色素沉着。磁共振成像(MRI)显示该肿瘤在T1加权像上呈高信号,在T2加权像上呈低信号。肿瘤进行了部分切除,并接受了辅助放疗。根据组织学检查以及中枢神经系统外无其他病变,确诊为原发性髓内黑色素瘤(PIM)。本文还对已报道的另外26例PIM病例进行了文献综述。PIM是极其罕见的肿瘤,但却是色素沉着性髓内肿瘤最常见的病因。只要有可能,完整手术切除是首选治疗方法,随后进行放疗。

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