脳室-腹腔シャントを介する腹腔内播種をきたした中枢神経系原発黒色腫 : 1剖検例の報告

概要

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An autopsy case of primary melanoma of the central nervous system is reported. An 11-year-old female was admitted complaining of headache and nuchal pain. At 2 months of age, a ventriculo-peritoneal (V-P) shunt had been performed after a diagnosis of communicating hydrocephalus. She had grown without any neurological deficits thereafter. On admission she was neurologically free except for a decreased patellar tendon reflex on the left side. Cerebrospinal fluid obthined by lumbar puncture was bloody. A computerized tomography scan showed a contrast positive mass in the left temporal base and diffuse enhancement of the subarachnoid space. The tumor was partially removed and diagnosed as a malignant melanoma. The patient developed various symptoms due to involvement of cranial nerves and the spinal cord. She died 2 months after a subarachnoid hemorrhage. Necropsy revealed diffuse leptomeningeal dissemination of the tumor in the central nervous system and peritoneal metastasis via a shunt tube. The authors suggest that peritoneal dissemination of melanomas in the central nervous system via V-P shunt system is not a rare occurrence; they make treatment more difficult.
日本脳神経外科学会の論文
1985-12-15