高年者のglioma

GLIOMA IN THE AGED

Ⅰ．はじめに

　原発性脳腫瘍の頻度は60歳を超えると急激に減少する^20）。そしてこの比較的稀な高年者の原発性脳腫瘍としては，とくにgliomaが多く，しかも悪性のgliomaが大部分を占めることが特徴とされている^{9,10,11,12）}。したがつて手術成績も遠隔成績も貧しいことが知られている^{1,2,4,8,12）}。以下著者らがてれまでに経験した高年者のglioma 14例について，とくにその特殊性に関して検討した。

Glioma is the most frequent primary brain tumor in the aged which is originally much less frequent comparing that of younger generations. A large majority of gliomas in the aged is malignant. Besides the result of operation and follow-up result have been heretofore reported as more unfavorable.

Fourteen cases of glioma in the aged, over 60 years of age, including 7 glioblastomas, 6 anaplastic astrocytomas and one unspecified malignant glioma, have been reported. Preoperative period varied from one month to 15 years and in 6 cases the period was less than 3 months. Poor preoperative state especially disturbance of consciousness mostly due to a markedly increased intracranial pressure, observed in 71% of the cases.

The malignant gliomas which were frequently seen among the aged might be transformed tumors of more benign gliomas which originated in the younger generations and developed slowly and silently. Unfavorable prognosis of glioma in the aged might be closely related to the histological nature and poor preoperative state. However, delay of making correct diagnosis and rapidly progressive onset both of which have been mentioned as the speciality of brain tumor in the aged, were not closely related to the unfavorable prognosis.