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Neurological Surgery No Shinkei Geka Volume 20, Issue 11 （November 1992）

Neurological Surgery 脳神経外科 20巻11号（1992年11月発行）

Japanese English

症例

原発性頭蓋内悪性黒色腫の1例 Primary Intracranial Melanoma: A case report 高野尚治 ¹ , 斎藤元良 ¹ , 村田晃一郎 ² , 大部誠 ³ , 宮坂佳男 ⁴ , 矢田賢三 ⁴ , 菅信一 ⁵ , 高木宏 ⁶ Shoji TAKANO ¹ , Motoyoshi SAITO ¹ , Kouichiroh MURATA ² , Makoto OHBU ³ , Yoshio MIYASAKA ⁴ , Kenzoh YADA ⁴ , Shin-ichi KAN ⁵ , Hiroshi TAKAGI ⁶ ¹北里研究所メディカルセンター病院脳神経外科 ²北里研究所メディカルセンター病院放射線科 ³北里研究所メディカルセンター病院病理 ⁴北里大学脳神経外科 ⁵北里大学放射線科 ⁶大和市立病院脳神経外科 ¹Department of Neurosurgery, Kitasato Institute Medical Center Hospital ²Department of Radiology, Kitasato Institute Medical Center Hospital ³Department of Pathology, Kitasato Institute Medical Center Hospital ⁴Department of Neurosurgery, Kitasato University School of Medicine ⁵Department of Radiology, Kitasato University School of Medicine ⁶Department of Neurosurgery, Yamato City Hospital キーワード： Malignant Melanoma , Primary brain tumor , ¹²³I-IMP-SPECT , DAV therapy , IFN—β Keyword: Malignant Melanoma , Primary brain tumor , ¹²³I-IMP-SPECT , DAV therapy , IFN—β pp.1211-1215

発行日 1992年11月10日 Published Date 1992/11/10

DOI https://doi.org/10.11477/mf.1436900562

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Abstract 文献概要
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I．はじめに

　黒色腫はneural crest由来のmelanocyteを発生母地とする腫瘍である．melanocyteは皮膚や粘膜に多く存在するが，中枢神経系では脳軟膜や脳内血管鞘に存在しており，脳底部や脳表に発生することがあり得るが，その頻度は極めて稀である．最近著者らは，脳軟膜に原発したと考えられる悪性黒色腫の1例を経験したので，文献的考察を加え報告する．

A rare case of primary intracranial melanoma is pre-sented in a 34-year-old man with initial symptoms of per-sistent headache. In magnetic resonance imaging (MRI), this case had all the characteristic findings of intracranial melanoma which had been reported previously.

In ¹²³I-iodoamphetamine-single photon emission CT (¹²³I-IMP-SPECT), abnormal accumulation of ¹²³-IMP was recognized in early and late phase imaging, which was very specific to the lesion. This is the first report of ¹²³-IMP-SPECT performed on a primary intracranial melanoma. Tumor mass originated from pia mater was surgically resected, but the dissemination of tumor cells was recognized macroscopically. Pathological examina-tion of the specimen showed very little malignant changes of melanoma cells, which was in contrast to the previous reports. Although, no standard chemotherapy of the primary intracranial melanoma has been estab-lished, DAV therapy to the dissemination of tumor cells into the subarachnoid space, and intravenous administra-tion of interferon-13 were performed in this case. Methods of differential diagnosis and treatments of primary in-tracranial melanoma are reviewed and discussed.