Reider-Groswasser I, Merimsky O, Karminsky N, Chaitchik S
Department of Radiology, Tel-Aviv Sourasky Medical Center, Ichilov Hospital, Sackler Faculty of Medicine, Tel-Aviv University, Israel.
Am J Clin Oncol. 1996 Feb;19(1):49-53. doi: 10.1097/00000421-199602000-00011.
The CT features of cerebral involvement by metastatic malignant melanoma are described in 28 patients. The most common locations of the primary lesion were the trunk and lower limbs. There was a high incidence of extracerebral metastasis at the time of diagnosis of cerebral involvement. Headache and behavioral changes were the most frequent presenting symptoms; 7% of patients with asymptomatic. The cerebral metastases were classified by size (< 1 cm, 1-4 cm, > 4 cm), with more than half measuring 1-4 cm. The larger lesions usually occurred singly. Peritumoral edema was detected in 89% of patients, hemorrhage in 19%, pressure signs on the ventricles in 37%, midline deviation in 15%, and leptomeningeal spread in 11%. No correlation was noted between size of tumor and other radiological features. Unilateral involvement was documented in 44% of cases. In the majority of patients the metastases were located at the periphery of the brain, mostly in the temporal and parietal lobes. Neuroimaging studies of the brain in asymptomatic patients with malignant melanoma may reveal occult metastases and influence the choice of treatment.
本文描述了28例转移性恶性黑色素瘤脑转移的CT特征。原发灶最常见的部位是躯干和下肢。在脑转移诊断时，脑外转移的发生率很高。头痛和行为改变是最常见的首发症状；7%的患者无症状。脑转移瘤按大小分类（<1cm、1-4cm、>4cm），超过一半的肿瘤大小为1-4cm。较大的病灶通常为单发。89%的患者检测到瘤周水肿，19%有出血，37%有脑室受压征象，15%有中线移位，11%有软脑膜播散。未发现肿瘤大小与其他影像学特征之间存在相关性。44%的病例记录为单侧受累。大多数患者的转移瘤位于脑周边，主要在颞叶和顶叶。对无症状恶性黑色素瘤患者进行脑部神经影像学检查可能会发现隐匿性转移，并影响治疗方案的选择。
