Líquido cefalorraquiano no diagnóstico de metástase cérebro-meníngea de melanoma maligno derivado de nevo melanocítico gigante congênito: relato de caso

 

Cerebral spinal fluid to diagnose CNS metastasis from malignant melanoma arising in a giant congenital melanocytic nevus: case report

 

 

José Augusto B. Rolim^I; Orlando G. R Barsottini^I; Gilmar F. Prado^II; Fernando Nakandakare^II; Maria L. A. A. Reis^III; J. B. Reis-Filho^IV

^IMédico-Residente do 3° ano de Neurologia da EPM-UNIFESP
^IIMédico Chefe do Plantão do Pronto Socorro de Neurologia da EPM-UNIFESP
^IIIBióloga do Setor de LCR da EPM-UNIFESP
^IVProfessor-Adjunto, Pesquisador do CNPq e Chefe do Setor de LCR da Disciplina de Neurologia da EPM-UNIFESP

 

 

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RESUMO

Relatamos o caso de um paciente, de 28 anos, portador de nevo melanocítico gigante congênito(NMGC), com transformação em melanoma e metastátase no sistema nervoso central (SNC). Descrevemos resumidamente as características patológicas de ambas as lesões(NMGC e melanoma), a frequência de malignização do NMGC, os órgãos mais frequentemente acometidos pelas metastases do melanoma - dando ênfase ao acometimento do SNC - além dos fatores que podem levar à malignização do NMGC, os exames usados para o diagnóstico das metástases no SNC - ressaltando a importância do líquido cefalorraquiano - e algumas modalidades terapêuticas para o melanoma com acometimento do SNC.

Palavras-chave: Melanoma maligno, metástase, sistema nervoso central, líquido cefalorraquidiano, nevo melanocítico gigante congênito.

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ABSTRACT

We describe the case of a 28-year-old man with a giant congenital melanocytic nevus (GCMN) with malignant transformation to melanoma and metastasis on the central nervous system (CNS). We also make a summary of the pathological features from both lesions(GCMN and melanoma), the occurrence of malignancy of GCMN, the organs more frequently involved with metastatic melanoma - with emphasis to involvement of CNS -just as the factors that cause malignant transformation of GCMN; the methods to diagnose metastases in CNS - emphasizing the importance of cerebrospinal fluid - and some therapeutical modalities for the metastatic melanoma in CNS.

Key words: Melanoma, metastases, central nervous system, cerebrospinal fluid, giant congenital melanocytic nevus.

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Aceite: 19-março-1996.

 

 

Estudo realizado no Pronto-Socorro de Neurologia da Disciplina de Neurologia da Escola Paulista de Medicina(EPM) da Universidade Federal de São Paulo(UNIFESP)
Dr. José Augusto Rolim - Disciplina de Neurologia, Escola Paulista de Medicina UNIFESP - Rua Botucatu 740 04023-062 São Paulo SP - Brasil.