Especialidad Médica en Neurocirugía, Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador.
Especialidad Médica en Neurocirugía, Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador.
Neurocirugia (Astur : Engl Ed). 2020 Nov-Dec;31(6):299-305. doi: 10.1016/j.neucir.2019.10.001. Epub 2019 Nov 25.
Nevus of Ota and nevus of Ito are hyperpigmentary dermal melanocytoses which develop as a consequence of disturbances or failures during migration of melanocytes from the neural crest towards the epidermis; they have a relatively unknown aetiopathogenesis and may be congenital or acquired.
This case involves a male patient with a simultaneous diagnosis of nevus of Ota and nevus of Ito at birth. He attended the Neurosurgery department at Carlos Andrade Marín hospital (Quito) with sudden severe headache associated with left brachio-crural hemiparesis.
Investigations revealed two extra-axial space-occupying lesions, one parasagittal at the right frontal and parietal lobes and the other located at the right temporal lobe pole. A surgical resection was planned for the parasagittal lesion and the histopathological diagnosis was meningeal melanocytosis. The temporal pole lesion was referred for treatment with Gamma Knife®.
Primary melanocytic neoplasms are extremely rare. There is evidence of their association with dermal melanocytosis and, in particular, with nevus of Ota. This highly unusual case describes the coexistence of two very rare dermal melanocytoses (nevus of Ota and nevus of Ito) and a primary melanocytic neoplasms in the same patient.
太田痣和伊藤痣是真皮黑素细胞增多症,是由于黑素细胞从神经嵴向表皮迁移过程中的干扰或失败而发展形成的;其病因发病机制尚不清楚,可能是先天性的,也可能是后天获得的。
本例患者出生时同时诊断为太田痣和伊藤痣。他因突发剧烈头痛伴左侧上下肢偏瘫到卡洛斯·安德拉德·马林医院(基多)神经外科就诊。
检查发现两个颅外占位性病变,一个位于右侧额顶叶矢状旁,另一个位于右侧颞叶极。计划对矢状旁病变进行手术切除,组织病理学诊断为脑膜黑色素细胞瘤。颞极病变转至伽玛刀治疗。
原发性黑色素细胞瘤极为罕见。有证据表明其与真皮黑色素细胞增多症有关,特别是与太田痣有关。本例非常罕见,描述了两种非常罕见的真皮黑色素细胞增多症(太田痣和伊藤痣)和同一患者的原发性黑色素细胞瘤同时存在。