硬膜内髄外に発生した脊髄血管芽細胞腫の2例

Intradural Extramedullary Hemangioblastoma of the Spinal Cord : Report of Two Cases

　抄録：血管芽細胞腫の多くは髄内発生であるが，今回比較的稀な硬膜内髄外に発生した血管芽細胞腫の2例を経験したので報告する．2例とも腫瘍は脊髄の後外側に存在し脊髄を著しく圧迫していた．腫瘍は術前MRIのT1強調像で等信号，T2強調像で高信号を呈しflow void signalもみられた．さらにガドリニウムで強く均一に増強される境界明瞭な腫瘤と，腫瘍頭尾側に線状に増強される陰影が特徴的であった．いずれも全摘出が可能で，症状の良好な改善が得られた．血管芽細胞腫の硬膜内髄外発生は稀であるが，鑑別診断の1つとして念頭に置くべきである．

　We report two rare cases of intradural extramedullary hemangioblastoma. In both cases the tumor was located in the posterolateral aspect of the spinal cord, and the spinal cord was severely compressed by the tumor. The T1-weighted MR images revealed an isointense mass, and the T2-weighted MR images revealed a high-intensity tumor surrounded by flow-void signals. Administration of gadolinium strongly and homogeneously enhanced the tumors and serpiginous areas above and below them. The tumors were totally excised, and the postoperative course was uneventful. Intradural extramedullary hemangioblastomas are rare, but should be included in the differential diagnosis when treating patients with an intradural extramedullary spinal cord tumor.