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題名 | Leptomeningeal Malignant Melanoma Arising in Neurocutaneous Melanocytosis:A Case Report=源自神經皮膚黑色素細胞瘤的軟腦膜惡性黑色素瘤:一病例報告 |
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作者 | 張振書; 謝佩圜; 賈力耕; 陳建州; 陳啟昌; 潘憲棠; 王有智; | 書刊名 | 中華醫學雜誌 |
卷期 | 60:6 1997.12[民86.12] |
頁次 | 頁316-320 |
分類號 | 415.689 |
關鍵詞 | 巨大先天性黑色素細胞痣; 水腦症; 軟腦膜黑色素瘤; 神經皮膚性黑色素細胞增生; Giant congential melanocytic nevus; Hydrocephalus; Leptomeningeal melanoma; Neurocutaneous melanocytosis; |
語文 | 英文(English) |
中文摘要 | 巨大先天性黑細胞痣並不常見。我們提出一例合併軟腦膜黑色素瘤且經病理切片證實的罕見病例。病人是26歲男性,其背部及左手臂出生即有一大片色素痣。住院前六個月開始有抽搐及腦壓增加的臨床症狀。核磁共振及一系列電腦斷層攝影追蹤檢查顯示水腦症、瀰漫性軟腦膜影像增強及在小腦、左頂葉有多個迅速長大且被對比劑清晰顯影的小瘤子。兩次的皮膚切片證實是真皮痣。顱內腫瘤的切片顯示源自黑色素細胞增生的惡性黑色素瘤。病人在病症出現一年後死亡。為儘快確立診斷,我們建議巨大先天性黑細胞痣的病人併有異常腦膜影像時,應作腦膜切片,或多做幾次腦脊髓液的細胞學檢查。 |
英文摘要 | A rare case of histology-proved giant congenital melanocytic nevus (GCMN) with symptomatic leptomeningeal melanocytosis is reported. A 26-year-old man had had a large patch of pigmented nevus over his back and left arm since birth. He had begun to have seizures as well as symptoms and signs of increased intracranial pressure about six months before admission. Serial computed tomography of brain showed hydrocephalus, diffuse leptomeningeal enhancement and multiple well-enhanced, rapid-growing nodules on the surface of the cerebellum and left parietal lobe. Magnetic resonance imaging (MRI) revealed T1 shortening of leptomeninges on precontrast T1 weighted imaging. Skin biopsy was done twice and showed intradermal nevus. Biopsy on one of the intracranial nodules revealed malignant melanoma arising in the melanocytosis. He died one year after the onset of neurologic symptoms. For early diagnosis of neurocutaneous melanocytosis, we suggest 1) MRI, and 2) leptomeningeal biopsy in patients with suspected leptomeningeal malignant me lanoma. |
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