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本文报告恶性黑色素瘤11例,其中颅内10例,椎管内1例,占同期中枢神经系统肿瘤0.28％。男性9例,女性2例;20～40岁有9例(81.8％)。症状期大多数在4个月以内。本组5例为转移性黑色素瘤,均查到原发病灶;6例为原发性黑色素瘤。本组有4例腰穿脑脊液呈血性或变黄;8例脑血管造影有4例出现病理性循环。原发性黑色素瘤缺乏典型症状及体征,术前诊断困难;但如皮肤或眼底视网膜存在黑色素瘤,则有助于颅内转移的诊断。对可疑病例应行脑脊液的瘤细胞检查。中枢神经系统黑色素瘤预后不佳。目前以手术切除肿瘤为好,必要时作减压术,术后配合激素、放疗及化疗,可缓解症状和延长生命。
This article reports 11 cases of malignant melanoma, including intracranial 10 cases, 1 case of spinal canal, accounting for 0.28% of central nervous system tumors over the same period. There were 9 males and 2 females, and 9 (81.8%) in 20-40 years old. The majority of symptoms are within 4 months. The group of 5 cases of metastatic melanoma, were found in primary lesions; 6 cases of primary melanoma. In this group, 4 cases of lumbar puncture cerebrospinal fluid was bloody or yellow; 4 cases of 8 cases of cerebral angiography showed pathological circulation. Primary melanoma lacks typical symptoms and signs and preoperative diagnosis is difficult; however, the presence of melanoma on the skin or fundus retina contributes to the diagnosis of intracranial metastases. Suspected cases of cerebrospinal fluid tumor cells should be checked. Central nervous system melanoma prognosis is poor. Currently surgery to remove the tumor is better, if necessary, decompression surgery, with hormones, radiotherapy and chemotherapy, can relieve symptoms and prolong life.