Objective: To explore the clinical manifestations, diagnosis, treatment and prognostic features of melanocytic neoplasms of central nervous system (CNS).
Methods: A total of 24 patients with melanocytic neoplasms of CNS underwent surgery and were confirmed pathologically our hospital during 2006 - 2012. Their clinical data were collected. There were primitive melanocytic neoplasms (n = 8) and metastatic melanoma (n = 16) according to the diagnostic criteria of Willis. The scans of magnetic resonance imaging (MRI) showed hyper-intensity on T1 weighted image (n = 15) and hypo-intensity on T2 weighted image (n = 20).
Results: The outcomes were total resection (n = 11), subtotal resection (n = 9) and partial resection (n = 4). All 8 primitive melanocytic neoplasms were followed up. Among them, 2 cases died postoperatively at 15 and 40 months respectively. The remaining 6 cases survived 13 - 56 months after craniotomy. And 14/16 patients of metastatic melanoma were followed up, 8 cases died and the mean survival period was 4.5 months. The remaining 6 cases survived 1-7 months after craniotomy. Immunohistochemical staining demonstrated that the positive rate of HMB-45 was 9/10, S-100 9/11 and Vimentin 8/11.
Conclusion: Melanocytic neoplasms of CNS are rare lesions with characteristic MRI features. Immunohistochemical staining helps to reach a definite pathological diagnosis. Surgical excision is recommended. Differentiation of primary and metastatic neoplasm is critical for prognostic evaluations.