颅内黑色素瘤的诊断和治疗

Diagnosis and treatment for intracranial melanoma

目的讨论颅内黑色素瘤的临床特点、影像学特征及治疗方案。方法回顾性分析11例经证实的颅内黑色素瘤患者的资料，分析其临床表现、影像学特征，并对其临床特点和治疗方案进行讨论。结果头部CT及MRI多可见瘤周有点状或条索状卫星灶。典型的黑色素瘤MRI表现为T1WI高信号、T2WI低信号，该表现具有特异性。11例手术中，4例全切，6例近全切，1例多发性转移瘤部分切除。术后患者多在3—12个月内死亡，最长不超过2年，平均生存期不到6个月。结论颅内黑色素瘤发病率低，误诊率高，治疗以手术切除为主，放化疗及免疫疗法仅可使部分患者受益，预后极差。

Objective To investigate the clinical features, imaging findings and treatment for intracranial melanoma. Method The clinical data, including presentation, imaging, treatment and prognosis of 11 patients with intracranial melanoma who underwent surgery were reviewed. Results Punctifotm or barred satellite nodules can be detected surrounding the capital tumor on CT and MRI. In melanic melanoma, the typical signal was hyperintensity in T1 -weighted MR imaging and hypointensity in T2 -weighted MR imaging. The distinctive features are different with other brain tumors. Total removal was achieved in 4 cases and subtotal resection in 6 cases, partial resection in 1 case. Histological examination showed all cases were melanoma. Most sufferers died 3 - 12 months after surgery, no patient survived over 2 years, mean survival time approximate to 6 months. Conclusions Intracranial melanoma is an extremely rare tumor and difficult to get correct preoperative diagnosis. Surgery removal of the lesion plays an important role in repressing tumor. Part of patients gain profit from radiotherapy, chemotherapy and immunotherapy. The prognosis is very poor.