Medical College, Binzhou Medical University, Yantai, Shandong, China.
Department of Spine Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China.
J Int Med Res. 2020 Aug;48(8):300060520947919. doi: 10.1177/0300060520947919.
Melanotic schwannoma (MS), a slowly growing nerve sheath tumor, is not a purely benign tumor. MS accounts for less than 1% of all nerve sheath tumors. We herein describe a rare case of MS and present a literature review focusing on the treatment of this disease. Twelve years before presentation at our hospital, a 41-year-old woman was examined because of an 8-month history of neck pain and 6-month history of upper extremity numbness and weakness. She underwent surgery to remove a tumor, and the pathological examination confirmed a diagnosis of MS. Twelve years later, at 53 years of age, the patient presented to our hospital with a 2-year history of neck pain and upper extremity numbness and weakness. Posterior cervical tumor resection was performed along with posterior cervical laminectomy, decompression and intraspinal space-occupying internal fixation, and radiotherapy. MS recurrence was confirmed. No tumor recurrence or metastasis was found after 7 months of follow-up. Recurrence of MS is rare, and its diagnosis depends on pathological features. Radical excision is the primary treatment for MS. Incomplete resection of MS is a risk factor for postoperative recurrence and metastasis. Furthermore, postoperative adjuvant radiotherapy should be performed to prevent recurrence and metastasis of MS.
黑色素性神经鞘瘤（MS）是一种生长缓慢的神经鞘肿瘤，并非纯粹的良性肿瘤。MS 占所有神经鞘瘤的比例不足 1%。我们在此描述了 1 例罕见的 MS 病例，并进行了文献复习，重点介绍了该病的治疗方法。患者，女性，41 岁，12 年前因颈痛 8 个月伴上肢麻木无力 6 个月就诊，行手术切除肿瘤，术后病理检查确诊为 MS。12 年后，53 岁时，患者因颈痛伴上肢麻木无力 2 年就诊。行后路颈椎肿瘤切除+后路颈椎椎板切除减压+椎管内占位内固定术，并进行了放疗。术后病理检查证实 MS 复发。随访 7 个月后，未见肿瘤复发或转移。MS 复发罕见，其诊断取决于病理特征。MS 的主要治疗方法为根治性切除，不完全切除是 MS 术后复发和转移的危险因素。此外，术后应行辅助放疗，以预防 MS 的复发和转移。
