硬膜外黑色素性神经鞘瘤1例并文献复习

目的探讨分析黑色素性神经鞘瘤(MS)的临床特点、诊断依据及治疗原则。方法回顾性分析2022年6月南京医科大学第一附属医院神经外科收治的1例以下肢疼痛为主诉的腰骶椎MS患者的临床资料，结合相关文献进行复习。结果MRI检查示，肿瘤压迫L5脊髓神经根。经手术治疗，患者疼痛症状明显改善，术后5天出院。当地医院随访复查无复发，患者至今正常生活。结论MS临床表现及影像学检查无明显特异性，诊断与鉴别诊断主要依靠病理学检查。手术切除是治疗该疾病的有效方式，放化疗可起到一定辅助效果。

Objective To analyze the clinical features, diagnostic basis and therapeutic principles of melanotic schwannoma(MS). Methods The clinical data of a patient with lower limb pain as the main complaint of lumbosacral spinal MS admitted to the Department of Neurosurgery, the First Affiliated Hospital of Nanjing Medical University in June 2022 were analyzed retrospectively, combined with relevant literature review. Results MRI examination showed that the tumor was pressing the L5 spinal nerve roots. The patient was discharged from hospital 5 days after surgery. Reexamination at the local hospital showed no recurrence of pain symptom and tumor. He has been living normally so far. Conclusions The clinical manifestations and imaging examination of MS have no obvious specificity. The diagnosis and differential diagnosis mainly depend on pathological examination. Surgical excision is effective to the disease, and radiotherapy and chemotherapy can play a certain auxiliary effect.