透明中隔付近より発生したと考えられる異所性松果体腫の摘出治験例

REPORT ON TREATMENT RESULTS IN ECTOPIC PINEALOMA APPARENTLY ARISIG FROM SEPTUM PELLUCIDUM

I．まえがき

　異所性松果体腫ectopic pinealomaとは，松果体腫が本来の松果体のあるべき位置，すなわち第三脳室尾背部壁から，四丘体の背部のcisterna ambiensに面した位置に初発するのではなくて，異所的に初発した場合をいうが，これが最も多く見られるのは，第三脳室底部のtuberal regionとされている。

　われわれは最近透明中隔付近より発生したと考えられる，きわめてまれなectopic pinealomaを経験し，摘出に成功したので報告する。

A 17-year-old high schod student was admitted because of headache, vomiting, failing vision. A year and 3 months prior to admission he noted the first of several brief episodes.

At hospitalization, physical examination showed increased intracranial pressure and choked disc, but no neuroiogicai residuals were found.

Examination performed by cerebral angiography and pneumoventriculography is a suspicion of the possible presence of tumor. Therefore, a left cranio-tomy was attempted. In the frontal lobe, apparently arising from the septum pellucidum, was a tumor the size of a small apple. Subtotal removal of the tumor was accomplished and the tumor could be seen extending from the ventral portion of the third ventricle to the anterior horn of the lateral ventricle via the foramen of Monro. The tumor is sharply defined and greysh-pink in color and felt firm throughout. The remainder of the tumor was irra-diated by X-ray with a total of 4000r in air.

Microscopic examination revealed the tumor to be "a typical two-cell pattern of ectopic pinealoma".

In a year period following surgery there has been no further incident. The patient is much improved and healthy now.