坐骨神経部に発生した慢性増大性血腫の1例

Chronic Expanding Hematoma of the Sciatic Nerve. Case Report

　慢性増大性血腫（choronic expanding hematoma，以下CEH）は，1カ月以上の経過で徐々に増大する血腫と定義されている．今回われわれは，坐骨神経部に生じたCEHの1例を経験したので報告する．症例は60歳，男性．1997年12月に坐骨神経痛を呈する左大腿部の腫瘤を認め，翌年3月に摘出術を施行されCEHと診断された．術後症状は消失したが，術後3年で腫瘤の再発と坐骨神経痛および軽度の麻痺症状を認めた．MRIによりCEHの再発と診断し，再度摘出した．手術後約1年の現在，再発は認めない．また，自験例においてMRI像はCEHの診断に有用であった．

　Chronic expanding hematoma (CEH) is defined as a hematoma that had grown for over 1month. In this report we describe a rare case of CEH of the sciatic nerve. Case: In December 1997, a 60-year-old man was admitted because of sciatic pain and a mass on the left thigh, and in March 1998, a mass on the sciatic nerve was resected. The histological diagnosis was hematoma, and clinically the hematoma was diagnosed as CEH. Three years after primary surgery, he again complained of sciatic pain and recurrence of the mass on the sciatic nerve. The mass was diagnosed as a recurrence of the CEH based on the MRI findings, and surgical resection was performed. There have been no recurrences during the one year since the second surgery. Our case demonstrates the usefulness of MRI for the diagnosis of CEH.