仮性脳腫瘍にて発症した大腸癌の1例

A CASE OF PSEUDOTUMOR CEREBRI ASSOCIATED WITH COLON CANCER

　抄録　仮性脳腫瘍が全身性の悪性腫瘍の合併症として発症することは稀であり，特に固形腫瘍で中枢神経系に転移を来さずに合併する場合はきわめて少ない。著者らは37歳の女性で，典型的な仮性脳腫瘍の症状を初発症状として発症し，諸検査の結果大腸癌が発見され手術により仮性脳腫瘍の症状が消失した稀な1例を経験した。本例は1年以上の追跡にて再発を認めておらず，末期症状としてではなく根治的に治療可能な時期に仮性脳腫瘍を主症状として発症した点が注目された。本例においては鉄欠乏性貧血が仮性脳腫瘍の主因と考えられた。

A case of pseudotumor cerebri associated with iron deficiency anemia due to colon cancer is re-ported in a 37-year-old woman. Her initial symp-tomes were vomiting and severe headache. On physical examination, no lymph nodes and abdomi-nal mass were palpable but marked anemia was noted in her skin and conjunctivus. Neurological examination revealed papilledema in her both eyes and stiffneck. There was no abnormal findings on CT scan on admission. Spinal puncture revealed CSF pressure as high as 620 mmH_2O with normal cells, protein, sugar and chrolide levels. Hemato-logical examination revealed iron deficiency ane-mia and thrombocytosis. Angiography at third day revealed no sinus occlusion, but retention of contrast media was seen on the cortical vein of parietal lobe and right transverse sinus. Brain scin-tigram at sixth day revealed mild accumulation in left parietal lobe, so small venous infarctioon was suggested. There were two circumscrived stenotic lesions of right ascending colon in the barium ene-ma, and right hemicolectomy was achieved. The pathological diagnosis was adenocarcinoma. The symptomes of pseudotumor cerebri was completely disappeared soon after the surgery together with resolution of anemia. She alives with no deficits now 1 year 3 months after surgery.

In conclusion much attention is necessary to a patient of pseudotumor cerebri with iron defi-ciency anemia for the presence of cancer, because not only this central nervous system lesion is reversible and curable but also the cancer itself may be curable by surgery.