対麻痺を呈した胸椎血管腫に対し放射線療法を行った1例

Radiation Therapy for Thoracic Vertebral Hemangioma with Paraplegia. Case Report

　対麻痺を呈した胸椎血管腫に対し放射線療法を行い，良好な経過を示した1例を経験したので報告する．症例は76歳の女性で，主訴は歩行困難であった．乳癌（10年前）の既往があり転移性骨腫瘍が疑われて入院となった．痙性歩行と左腸腰筋の筋力低下および足クローヌスを認めた．L1以下に2/10の知覚鈍麻を認めた．MRIにてTh7にT1強調像で低信号，T2強調像で高信号の陰影および同部位の脊髄の圧迫を認め転移性骨腫瘍を疑ったが，生検にて血管腫と診断した．計30Gyの放射線照射を行い，両下肢筋力の改善，足クローヌスの消失を認め対麻痺は改善した．

　We report a case in which radiation therapy for a thoracic vertebral hemangioma with paraplegia proved effective. The patient was a 76-year-old woman whose chief complaint was dysbasia and who had a history of breast cancer 10 years previously. She was admitted because of suspicion of a metastatic bone tumor. She had a spastic gait, weakness of the left iliopsoas muscle, bilateral ankle clonus, and 2/10 hypesthesia in the region below L1. Magnetic resonance imaging (MRI) showed a shadow that was low signal intensity on T1 weighted images and high signal intensity on T2 weighted images, and spinal cord compression. We therefore suspected a metastatic bone tumor, but a biopsy revealed a hemangioma. After radiation therapy (exposure dose 30Gy), muscle in both lower limbs strength improved, ankle clonus resolved,and the paraplegia improved.