椎管内原发性黑色素细胞肿瘤(附5例报告)

Intraspinal primary melanocytic neoplasms:report of 5 cases

目的总结椎管内原发性黑色素细胞肿瘤的临床特点。方法分析5例椎管内黑色素细胞起源肿瘤病人的临床资料,结合文献,对其流行病学、病理类型、影像特征、诊治和预后等进行讨论。结果本组男3例,女2例;年龄31￣47,平均38.2岁。椎管内肿瘤单发4例,多发1例;髓外硬膜下4例,髓内1例。短T1、短T2信号为其典型MRI特征。病理诊断为恶性黑色素瘤3例,黑色素细胞瘤2例。不同病理类型的治疗方法和预后迥然不同。结论早期诊断、显微手术全切除是获得良好预后的关键;应根据不同病理类型采取适宜的放、化疗措施。

Objective To summarize the clinical characteristics of primary intraspinal melanocytic neoplasms. Methods The clinical materials of five cases of primary intraspinal melanocytic neoplasms were retrospectively reviewed. The epidemiological characteristics, pathological type, imaging features, diagnostic methods, therapeutic measures and prognosis were discussed in detail after reviewing the literatures. Results In this group, 3 cases were male, and 2 were female. The age ranged from 31 to 47 years with a mean of 38.2 years. The intraspinal tumor was single in 4 cases, and multiple in 1. Four cases were diagnosed of extramedullary hypodura tumors, and 1 intramedullary. The typical short T1 and T2-weighted MR signal intensities suggested the melanocytic origin of the tumor. Pathology showed malignant melanoma in 3 cases, and melanocytoma in 2. Therapeutic methods and prognosis were utterly different between the pathological types. Conclusion Early diagnosis and total removal of tumor by microsurgical techniques are the keys of good prognosis of melanocytic neoplasms. According to different pathological types, suitable radiotherapy and chemotherapy should be adopted.