脊髄膠芽細胞腫の1例

A CASE OF SPINAL CORD GLIOBLASTOMA

I．いとぐち

　1887年Gowers　＆　Horsley^1）により脊髄種瘍の外科的摘出がはじめて行なわれて以来，脊髄腫瘍に関する報告は多数みられる。しかしそれらの大部分は硬膜内髄外腫瘍または硬膜外腫瘍であり，髄内腫瘍は10％内外にすぎなく^2），そのうちでも膠細胞腫は稀で，しかもその50％以上は脳室上衣腫で，悪性度のもつとも高い膠芽細胞腫例は1936年のFlock^3）の剖検第1例の報告後にも散見されるにすぎない。

　著者らは，両下肢の弛緩性麻痺を主訴とする患者において上位腰髄節脊髄腫瘍の診断のもとに手術を行なったところ膠芽細胞腫であることを知り，その後，経過観察を行なうとともに剖検する機会を得たので撮告する。

Since the first description dy Gowers and Hors-ley (1887) on the surgical treatment of spinal cord tumor, many articles had been published. However the report on the spinal cord glioma (except epen-dymoma) are very few until present time and par-ticularly, glioblastoma is very rare.

The authors had reported a case of spinal cord glioblastoma.

The patient is 23 years old man and his history had started two months prior to admission with severe lumbago, following disturbance of urination and gait disturbance. He had admitted in our clinic because of complete flaccid palsy and sensory dis-turbance of lower limbs.

The myelography done by cisteral puncture after admission revealed complete occlusion in tenth thoracic vertebral level. The diagnosis of intrame-dullary tumor had made by operation. The operation had limited in palliative external decompression by mean of transplantation of fascia graft.

The patient's general condition had become wor-se and expired 68 days after operation.

The postmorten examination had made and detail serial histological examination of whole central ner-vous system had done. The tumor was glioblasto-ma microscopically and occupied from 3rd thoracic segment to 1st lumbal segment.