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Brain and Nerve No to Shinkei Volume 22, Issue 9 （September 1970）

Brain and Nerve 脳と神経 22巻9号（1970年9月発行）

Japanese English

症例報告

多彩な神経内分泌症状を呈したPlexus Papillomaの1例 A CASE OF CHOROIDPLEXUS PAPILLOMA WITH A MOSAIC NEUROENDOCRINE PICTURE 大槻真 ¹ , 大倉久直 ¹ , 玉岡昌則 ¹ , 佐古田雅弘 ¹ , 山村武平 ¹ , 堀公行 ² , 藤田稠清 ² , 船曳紀之 ³ Makoto Otsuki ¹ , Hisanao Ookura ¹ , Masanori Tamaoka ¹ , Masahiro Sakoda ¹ , Takehira Yamamura ¹ , Kimiyuki Hori ² , Sigekiyo Fujita ² , Tosiyuki Funabiki ³ ¹神戸大学医学部第2内科 ²神戸大学医学部第1外科 ³神戸大学医学部第2病理 ¹2nd Department of Internal Medicine, Kobe University School of Medicine ²1st Department of Surgery, Kobe University School of Medicine ³2nd Department of Pathology, Kobe University School of Medicine pp.1071-1077

発行日 1970年9月1日 Published Date 1970/9/1

DOI https://doi.org/10.11477/mf.1406202783

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Abstract 文献概要
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はじめに

　1954年Bauer^1）によつて視床下部障害に関する臨床病理学的検討が報告され，その中で視床下部障害が特異な内分泌代謝環境を構成していること，臨床症状もまた多彩であることなどを報告したが，当時の記載は主として身体所見の記載にとどまり，内分泌代謝学的検索は極度に乏しく，新らしい神経内分泌学的手段を行使しての検討はその後も少ない。

　また視床下部以外の中枢神経系の障害においても内分泌代謝障害の可能性は高いが，この点についても系統的な観察は決して多くない。臨床的実験的成績から内分泌，特に下垂体機能の中枢神経系による支配機序が明らかにされつつあるが，このような観点からも神経内分泌学的検索の施行された中枢神経障害症例の集積は意味のあることと考えられる。

Choroidplexus papilloma is a rare brain tumor. This case is a typical plexus papilloma of 14 years old boy originated from the right ventricle and destroied the right hippocampus. Metastatic lesion was found in hypothalamus which was destroied completely.

About the end of 9 years old bulimia and obesity appeared, thereafter hyperthermia, psychic dister-bances, hypogonadism, somnolence, anorexia, visualdisturbances and disturbances of sphincteric control appered successively, and satisfied 10 symptoms out of 13 which Bauer showed as hypothalamic-linked synptoms. It is not clear that these various symptoms are due to diffuse destruction of hippocampus. It is necessary to summarise and analyse the symptoms accompanied with limbic-system lesions.

In this case plasma cortisol and growth hormone response to hypoglycemia were impaired but the response to SU 4885 was preserved. This suggests the difference of stimulating points between hy-poglycemia and SU 4885 and showed that anterior pituitary hormones are regulated by central nervous system and the response to stimulations are different.That is, hypoglycemia has its effecting point in central nervous system whereas the decrese of plasma cortisol in pituitary gland.

Hypernatremia is due to the lesion of thirst center located in hypothalamus and to the insufficiency of ADH secretion.

By hormone replacement therapy polyuria ap-pered. This is bacause of coexisting anterior pitui-tary and neurohypophyseal insufficiency.

We disscussed about neuroendocrine symptoms with special reference to lesions of limbic systems including hippocampus and the mechanisms of pitui-tary control by central nervous systems.