Department of Neurosurgery, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China.
Department of Neurosurgery, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China.
World Neurosurg. 2018 Jun;114:76-83. doi: 10.1016/j.wneu.2018.02.007. Epub 2018 Mar 10.
To explore the clinical characteristics of neurocutaneous melanosis (NCM) in adult patients to help improve diagnosis and treatment of this disease, we present a rare case of an adult patient suffering from NCM with malignant melanoma, as well as a review of the relevant Chinese and English literature.
The patient reported here plus the patients identified in our literature review total 30 adults with NCM (20 males [66.7%] and 10 females [33.3%]), age 19-65 years (average, 27.9 years). These include 24 cases of malignant melanoma (80.0%), 3 cases of melanocytoma (10.0%), 2 cases of diffuse melanocytosis (6.7%), and 1 case of unknown pathology (3.3%). Satellite nevi were reported in 25 cases (83.3%) and in 5 cases their presence was unknown (16.7%). Intracranial lesions were present in 28 cases (93.3%), and intraspinal lesions were present in 2 cases (6.7%). There are 4 cases of combined hydrocephalus (13.3%), and 2 cases of combined Dandy-Walker deformity (6.7%).
NCM is a rare disease, especially in adults. With the onset of symptoms, the diagnosis is generally confirmed. In children with congenital giant nevus, regular periodic surveys of the central nervous system (brain and spinal cord) with magnetic resonance imaging or cerebrospinal fluid analysis should be performed to diagnose NCM. Active treatment should be undertaken to improve the prognosis.
为了探索成人神经皮肤黑变病(NCM)的临床特征,以帮助提高对该病的诊断和治疗水平,我们报告了 1 例成人伴恶性黑色素瘤的 NCM 罕见病例,并复习了相关的中文和英文文献。
本例患者加我们文献复习中确定的患者共有 30 例成人 NCM(20 例男性[66.7%]和 10 例女性[33.3%]),年龄 19-65 岁(平均 27.9 岁)。其中恶性黑色素瘤 24 例(80.0%),黑素细胞瘤 3 例(10.0%),弥漫性黑色素增多症 2 例(6.7%),1 例病因不明(3.3%)。25 例(83.3%)有卫星痣,5 例(16.7%)情况不明。28 例(93.3%)颅内有病变,2 例(6.7%)脊髓有病变。有 4 例合并脑积水(13.3%),2 例合并 Dandy-Walker 畸形(6.7%)。
NCM 是一种罕见疾病,尤其是在成人中。出现症状后,一般可确诊。对先天性巨痣患儿,应定期进行脑(包括脊髓)磁共振成像或脑脊液分析等中枢神经系统检查,以诊断 NCM。应积极治疗以改善预后。