软脑膜原发性恶性黑色素瘤系一罕见肿瘤,我们迂到一例生前被误诊为结核性脑膜炎。死后经尸体解剖病理检查证实为该病。现报道如下: 病历摘要患者,女性,48岁,农民,住院号10374。患者诉1977年12月起,走路时感背部疼痛,休息时减轻或消失。尔后,疼痛逐渐向骶尾部发展扩大,一年后,上述症状加剧并出现颈转动时头痛,呈两下肢牵拉样痛,骶尾部麻木,解大便也感困难。在某医院检查类风湿因子阴性;颈椎摄片正常。发病后曾经针灸及中西药治疗,效果不佳,病情白渐加重,于1978年2月7日转来本院。既往史无殊。入院时检查体温38.7℃,脉搏70次/分,呼吸16次/分,血压120/80毫米汞柱。发育营养中等,神清合作,左乳头外上方有一个1.5×2厘米灰褐色乳头状痣,表浅淋巴结不肿大,瞳孔圆形等大,光反射良好,鼻唇沟两侧对称,无紫绀,颈抵抗,心肺正常,腹软无压痛,肝脾未及,两肾区及脊椎(胸、腰、骶椎)明显叩击痛,四肢肌力、肌张力 Primary malignant melanoma meningioma is a rare tumor that we are misdiagnosed as tuberculous meningitis. After death by autopsy pathology confirmed the disease. Reported now are as follows: Medical records summary of patients, female, 48 years old, farmer, hospital number 10374. Patient v. Beginning December 1977, back pain during walking, relief from or loss of rest. Later, the pain gradually expanded to the development of the sacrococcygeal, a year later, the above symptoms aggravated and headache when the neck rotation, showed two legs pulling pain, sacrococcygeal numbness, stool solution difficult. Rheumatoid factor negative in a hospital examination; normal cervical spine. After the onset of acupuncture and Western medicine has been used, the effect is not good, the disease gradually increased white, on February 7, 1978 transferred to the hospital. Past history without special. Admission examination temperature 38.7 ℃, pulse 70 beats / min, breathing 16 beats / min, blood pressure 120/80 mm Hg. Development of nutrition medium, Shenqing cooperation, the left above the nipple there is a 1.5 × 2 cm gray brown papillary nevus, superficial lymph nodes is not enlarged, pupil circular and other large, good light reflection, bilateral nasolabial fold symmetry, no cyanosis , Cervical resistance, normal cardiopulmonary, soft abdominal tenderness, liver and spleen not yet, two kidney area and the spine (chest, waist, sacral vertebra) obvious percussion pain, muscle strength, muscle tension