颅内恶性黑色素瘤的CT及MRI的表现及临床病理学研究

Diagnosis and treatment of intracranial malignant melanoma

目的:颅内恶性黑色素瘤是颅内比较罕见的肿瘤,发病率较低。本文探讨颅内黑色素瘤的影像学表现,诊断,病理。方法:回顾性研究我院近20年来16例临床病理诊断为颅内恶性黑色素瘤的患者病例,这些患者均进行过手术治疗,根据其影像学表现、病理诊断及其预后进行细致分析。结果:这16例颅内黑色素瘤患者的症状以颅内占位效应、癫痫与神经系统损害定位症状为主。CT与MRI表现多种多样,差异性较大,MRI具有短T1,短T2典型表现有10例患者。病理诊断为上皮样黑色素细胞瘤共有13例,免疫组化特异性标记物S-100(溶解蛋白)和HMB-45(人黑色素相关抗原)可以用来辅助对黑色素瘤的病例诊断。结论:颅内黑色素瘤的临床表现及影像学诊断缺乏特异性,术中所见与病理诊断是其确诊的主要方法。

Obiective ：Intracranial malignant melanoma was comparatively rare in intracranial tumors with a lower incidence. This paper discusses the imaging findings, diagnosis, pathology. Methods： Retrospective study of nearly 20 years in our hospital 16 patients with pathological diagnosis for patients with intracranial malig- nant melanoma cases, who underwent surgical treatment, according to the imaging findings, pathological diagnosis and prognosis were analyzed carefully. Result： Major manifestations of 16 cases of intracranial malignant melanoma were mass effect, epilepsy and local symptom. Various signal appearance was found in CT and MRI scan. 10 cases were typical in MRI scan. Epithelioid cells were found in 13 cases in pathologic diagnosis. Sensitivity of S-100 and specifically bind to HMB-45 were helpful for diagnosis. Conclusion ：Clinical manifestation of intracranial malignant melanoma is not specific, so most diagnosis depend on intraoperation findings and pathology.