乳癌頭蓋骨転移によりCollet-Sicard症候群を呈した1例

SKULL BASE METASTASIS OF THE BREAST CANCER CAUSING THE COLLET-SICARD SYNDROME : A CASE REPORT

I．はじめに

　脳神経が種々の組合わせでおかされた時，いろいろな人名を冠した名称で呼ばれていることはよくしられている。今回，われわれは，乳癌根治術後10年を経て，癌が頭蓋骨底に転移し，その結果一側脳神経IX, X, XI，XII，が同時におかされたCollet-Sicard症候群を呈した症例を経験したので若干の考察を加えて報告する。

A 51-year-old female presented herself with complaints of mis-swallowing, hoarseness, speech disturbance and right stiff shoulder of 3 months duration. She had left breast cancer operated on elsewhere 10 years previously. Pertinent neuro-logical findings were 9th, 10th, 11th and 12th cranial nerve palsies on the right (the Collet-Sicard syndrome). Cerebral angiography, retrograde jugular venography, polytomography of the skull base and bone scintigraphy with ^99mTc-MDP raised a question of metastasis of the breast cancer to the skull base of the right mastoid region. Follow-ing right retromastoidal suboccipital craniectomy, partial removal of the metastatic skull tumor of the deep mastoid region was done. No intracranial extension of the tumor was confirmed. Multiple cranial nerve palsies above mentioned resolved following irradiation with betatron of 5000 rads. Pathology report was that of metastatic adeno-carcinoma to the skull, which was similar to the histology of the breast cancer resected 10 years previously. Skull base metastasis of the breast cancer causing the Collet-Sicard syndrome is rare. To the author's knowledge, only 7 cases of the Collet-Sicard syndrome caused by metastatic tumors have been reported in the English and Japanese literatures. Primary lesions were as follows : The one was from the lung and the rest were all from the prostate. We are reporting the first case of the Collet-Sicard syndrome due to metastatic ariennrarrinoma of the breast to the skull base.