髓内黑色素性施万瘤：一种罕见肿瘤的罕见表现。病例报告。
Intramedullary melanotic schwannoma: a rare presentation of a rare tumor. Illustrative case.
作者信息
McCann Margaret M, Hain John D
机构信息
1Department of Translational Neuroscience, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
2Department of Biomedical Sciences, Creighton University, Omaha, Nebraska; and.
出版信息
J Neurosurg Case Lessons. 2023 Feb 13;5(7). doi: 10.3171/CASE22391.
BACKGROUND
Intramedullary melanotic schwannomas (IMSs) are rare spinal cord tumors, and a hemorrhagic IMS is an even rarer presentation of this uncommon lesion. The authors describe the second known case of a hemorrhagic IMS and briefly review the characteristics of IMSs.
OBSERVATIONS
The patient's initial presentation and imaging indicated an intramedullary thoracic spinal cord tumor impairing lower extremity function. Intraoperatively, the lesion appeared pigmented and hemorrhagic. Pathologic analysis determined the tumor to be an IMS.
LESSONS
Melanotic schwannomas vary in presentation and can resemble malignant melanoma but are differentiated by pathologic markers. Lesions typically present as extramedullary masses in the thoracic cord. Intramedullary presentation is rare but should be considered for pigmented tumors.
背景
髓内黑色素性神经鞘瘤（IMSs）是罕见的脊髓肿瘤，而出血性IMS是这种罕见病变中更为罕见的表现形式。作者描述了第二例已知的出血性IMS病例，并简要回顾了IMSs的特征。
观察结果
患者最初的表现和影像学检查提示为髓内胸段脊髓肿瘤，影响下肢功能。术中，病变呈现色素沉着且有出血。病理分析确定该肿瘤为IMS。
经验教训
黑色素性神经鞘瘤表现各异，可类似恶性黑色素瘤，但可通过病理标记物进行鉴别。病变通常表现为胸段脊髓的髓外肿块。髓内表现罕见，但对于色素性肿瘤应予以考虑。
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