Maiellaro Alfonso, Perna Antonio, Giugliano Pasquale, Esposito Massimiliano, Vacchiano Giuseppe
Legal Medicine Department, A. Cardarelli Hospital, 80131 Naples, Italy.
Pathology Unit, Mauro Scarlato Hospital, 84018 Scafati, Italy.
Healthcare (Basel). 2021 Mar 17;9(3):341. doi: 10.3390/healthcare9030341.
Primary cerebral tumors rarely provoke sudden death. The incidence is often underestimated with reported frequencies in the range of 0.02 to 2.1% in medicolegal autopsy series. Furthermore, primary cerebral melanoma is an uncommon neoplasm. It represents approximately 1% of all melanoma cases and 0.07% of all brain tumors. This neoplasm is very aggressive, and its annual incidence is about 1 in 10 million people. In the present study, a 20-year-old male was admitted to hospital with vomiting, headache, paresthesia and aggressive behavior. A computed tomography (CT) scan of the head was performed showing a hyperdense nodule in the right parietal lobe with inflammation of the Silvian fissure. A complete autopsy was performed 48 h after death. A blackish material was displayed on the skull base, and posterior fossa. Microscopic examination diagnosed primary brain melanoma. A systematic review of the literature was also performed where no previous analogous cases were found. The forensic pathologist rarely encounters primary cerebral melanoma, and for these reasons, it seemed appropriate to describe this case as presenting aspecific clinical symptoms and leading to sudden unexpected death. Histopathological observations are reported and discussed to explain this surprising sudden death caused by a primary cerebral melanoma.
原发性脑肿瘤很少引发猝死。其发生率常常被低估，在法医学尸检系列报道中，频率范围为0.02%至2.1%。此外，原发性脑黑色素瘤是一种罕见的肿瘤。它约占所有黑色素瘤病例的1%，占所有脑肿瘤的0.07%。这种肿瘤极具侵袭性，其年发病率约为每1000万人中有1例。在本研究中，一名20岁男性因呕吐、头痛、感觉异常和攻击性行为入院。进行了头部计算机断层扫描（CT），显示右顶叶有一个高密度结节，伴有外侧裂炎症。死后48小时进行了完整的尸检。在颅底和后颅窝发现了黑色物质。显微镜检查诊断为原发性脑黑色素瘤。还对文献进行了系统回顾，未发现以前类似的病例。法医病理学家很少遇到原发性脑黑色素瘤，因此，将该病例描述为表现出非特异性临床症状并导致意外猝死似乎是合适的。报告并讨论了组织病理学观察结果，以解释由原发性脑黑色素瘤引起的这种令人惊讶的猝死。
