Department of Neurosurgery, All India Institute of Medical Sciences, New-Delhi, India.
Department of Neuropathology, All India Institute of Medical Sciences, New-Delhi, India.
Neurol India. 2022 Jan-Feb;70(1):340-344. doi: 10.4103/0028-3886.338696.
Primary intracranial malignant melanomas (PIMMs) are uncommon lesions of the central nervous system. Brainstem involvement is of rare occurrence.
A 33-year-old male presented with the chief complaints of progressively increasing headache, visual disturbances, and diplopia from the last 6 months. Magnetic resonance imaging (MRI) showed a well-defined lesion in the midbrain appearing heterogeneously hyperintense on T1WI and containing mixed hyperintense and hypointense areas on T2WI. Multiple areas of SWI blooming, suggestive of hemorrhage, were seen within the lesion.
Brainstem malignant melanoma can masquerade cavernoma as seen in our case. Therefore, malignant melanomas should be considered in the differential diagnosis of brainstem lesions that presents with bleed.
原发性颅内恶性黑色素瘤（PIMMs）是中枢神经系统中罕见的病变。脑干受累很少见。
一名 33 岁男性因头痛进行性加重、视力障碍和复视从最后 6 个月出现为主诉。磁共振成像（MRI）显示中脑内有一个界限清楚的病变，T1WI 呈不均匀高信号，T2WI 包含混合高信号和低信号区域。病变内可见多个 SWI 晕征，提示出血。
如我们的病例所见，脑干恶性黑色素瘤可能伪装为海绵状血管瘤。因此，对于以出血为表现的脑干病变，应考虑恶性黑色素瘤的鉴别诊断。
