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AN AUTOPSY CASE OF CLIVUS CHORDOMA WITH PEDUNCULAR HALLUCINOSIS Motohiro Suetsugu 1 , Mitsumasa Abe 2 , Kazuhiro Deshimaru 2 , Naotaka Shinfuku 3 1Department of Neuropsychiatry, Faculty of Medicine, Kyushu University 2Fukuoka Central National Hospital 3Hizen National Sanatorium pp.1209-1214
Published Date 1974/12/1
DOI https://doi.org/10.11477/mf.1406203635
  • Abstract
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Clinical and pathological findings of a case ofclivus chordoma with peduncular hallucinosis werereported.

A 44 years-old woman who had 2 years historyof right sided cranial polyneuropathy (V, VI, IX),was diagnosed for chordoma by biopsy of theepipharynx tumor.

Inspite of radiation therapy, the epipharynxtumor had grown larger and transoral partial re-section of the tumor was performed.

About 3 months after the operation, peculiarhallucinations were observed which many personsor queer dolls were seen moving about. Moreover,she saw a man standing in her left sided visualfield who moved to left aside when she would lockat him. During this episode, her sleep-wake rhythmwas well preserved and she developed no delusionalideas. Neurological examination revealed bil. anos-mia, oculomotor palsy (r>1), papilloedema (r>1),gaze nystagmus (r>1), abducens palsy, absence ofcorneal reflexes and rt. glossopharyngeal palsy.No involuntary movements, no ataxia and no longtract signs were observed.

One and half months after the onset of thosehallucinations, she expired under coma. Postmortem examination revealed a huge sphericaltumor in the center of the skull basis and theclivus which compressed the posterior half of orbitalbrain, optic chiasma, hypothalamus, temporal lobes,cerebral peduncles, pons and medulla oblongata.There were also scattered foci of fresh softeningin cerebral cortices and basal ganglia.

We supposed that her peculiar hallucinationswere similar to those of peduncular hallucinosis(Lhermitte) and that they appeared probably bycompression of the tumor to the brain-stem.


Copyright © 1974, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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