Gu Seema, Pant M C, Husain N, Sundar S, Singh P K
Department of Radiotherapy, C.S.M. Medical University, Lucknow, Uttar Pradesh, India.
Department of Pathology, C.S.M. Medical University, Lucknow, Uttar Pradesh, India.
J Radiosurg SBRT. 2012;1(4):339-341.
Primary intraparenchymal brain melanocytic lesions are very rare and arise from leptomeninges in the superficial cortex with invariably poor clinical outcome. We report a case of a 45-year old male who presented with an intraparenchymal brain lesion without meningeal involvement, radiologicallly consistent with primary brain tumor. However, the pathology of excisional biopsy proved to be melanoma on histopathology and immunohistochemistry. Treatment consisted of limited surgery followed by local radiotherapy with the patient had no significant clinical improvement, and was managed conservatively with steroids along with chemotherapy. The patient died due to diffuse intracranial dissemination within 4 months from completion of radiotherapy.
原发性脑实质内黑色素细胞病变非常罕见，起源于浅表皮质的软脑膜，临床预后总是很差。我们报告一例45岁男性，其脑实质内有病变，无脑膜受累，影像学表现与原发性脑肿瘤一致。然而，切除活检的病理结果在组织病理学和免疫组化上证实为黑色素瘤。治疗包括有限的手术，随后进行局部放疗，但患者临床症状无明显改善，遂采用类固醇及化疗进行保守治疗。患者在放疗结束后4个月内因颅内弥漫性播散而死亡。
