広範な頭蓋外骨転移のみられた小脳medulloblastomaの剖検例

CEREBELLAR MEDULLOBLASTOMA METASTASIZING OUTSIDE THE CENTRAL NERVOUS SYSTEM: REPORT OF A CASE

はじめに

　脳腫瘍が中枢神経系以外に転移することについては，その是非が論議されて来たが^19），Rubinstein^15），Anzil^1）はastrocytomaの非手術例で遠隔転移を報告しており，また稀ではあるがmedulloblastomaの症例で頭蓋外に遠隔転移することが知られている。

　最近私達は9歳の男子で，脳脊髄と硬膜の表面の広範な転移の外に，左脛骨頭，左右肋骨，及び頭蓋骨等の主に骨系統に頭蓋外転移を来たしたmedulloblastomaの症例を経験したので，文献的考察を行ない報告する。

A case of cerebellar medulloblastoma metasizing outside the central nervous system was herein reported in detail with twenty cases reported so far in the literature.

A 9-year-old boy was admitted with chief com-plaint of headache and vomitting. A space oc-cupying lesion was revealed in the posterior fossa, and a tumor was removed in the light cerebellar hemisphere. Six months after the first operation the dissemination of tumor was found roentgeno-logically in the skull, ribs, and tibia. These find-ing were confiemed at autopsy with diffuse spread of the tumor to the central nervous system. The invation of the tumor cell on the inner surface of the dura into the superior sagittal sinus was demonstrated microscopically. This seemed to be a pathway of the extracranial dissemination in our case.