Goutham Cugati, Kumar Jain Pradeep, Anil Pande, Peter Symss Nigel, Ravi Ramamurthi, Chakravorthy Vasudevan Mathabushi
Dr. Achanta Lakshmipathi Neurosurgical Center, Post Graduate Institute of Neurological Surgery, Voluntary Health Services Hospital, Chennai - 600113, India.
World J Oncol. 2011 Apr;2(2):79-82. doi: 10.4021/wjon285w. Epub 2011 Apr 9.
Cutaneous melanoma can metastasize to any organ, including brain and spinal cord. A 27-year-old lady, four months after conception presented with generalized seizures and was diagnosed to have subarachnoid hemorrhage. Further investigation did not reveal aneurysm. She underwent right ventriculo-peritoneal shunt for hydrocephalus and MTP for unprotected radiation from CT scan. Six weeks later she came to our institution with symptoms of dorsal compression. Imaging showed multiple intradural extramedullary spinal lesions at D3-D4, D8 and D10-D11. Surgical excision of the lesions was done and histopathology was consistent with metastatic deposits from malignant melanoma which was confirmed by immunohistochemistry studies also. Her conscious level deteriorated on the second postoperative day and CT scan showed multiple small tumor emboli with evidence of right temporal bleed and diffuse cerebral edema. In spite of aggressive treatment she could not be saved. This reported case concludes that pregnancy aggravates the clinical course of metastatic melanoma.
皮肤黑色素瘤可转移至任何器官，包括脑和脊髓。一名27岁女性，怀孕四个月时出现全身性癫痫发作，被诊断为蛛网膜下腔出血。进一步检查未发现动脉瘤。她因脑积水接受了右心室-腹腔分流术，并因CT扫描的无防护辐射接受了中期妊娠终止术。六周后，她因背部受压症状前来我院。影像学检查显示在胸3-胸4、胸8和胸10-胸11水平有多个硬脊膜内髓外脊髓病变。对病变进行了手术切除，组织病理学结果与恶性黑色素瘤转移灶一致，免疫组织化学研究也证实了这一点。术后第二天她的意识水平恶化，CT扫描显示多个小肿瘤栓子，伴有右侧颞叶出血和弥漫性脑水肿的迹象。尽管进行了积极治疗，她还是没能挽救过来。本报告病例表明，妊娠会加重转移性黑色素瘤的临床病程。
