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症例は75歳の男性で,2カ月前からの両側の腰下肢痛と脱力を主訴に受診した.MRIで第12胸椎(T12)/第1腰椎(L1)椎間高位の脊柱管背側に腫瘤を認め,黄色靱帯内血腫と診断し手術を行った.手術はT11-L1椎弓切除術を行い,黄色靱帯に連続した暗褐色腫瘤を摘出した.内容は暗赤色で粘調・チョコレート様で,病理組織診断は黄色靱帯内血腫であった.脊柱管内腫瘤性病変の鑑別診断の1つとして黄色靱帯内血腫を考慮する必要がある.また黄色靱帯内血腫の報告は腰椎高位の発生例が多いが,本症例は比較的稀な胸腰椎移行部にみられた.
A 75-year-old man was admitted to our hospital with a 2-month history of low back pain and weakness of the both legs. MRI revealed a ligamentum flavum hematoma in the thoracolumbar spine. At surgery a dark brownish mass was found in the ligamentum flavum, and histopathological examination revealed that the mass was a typical ligamentum flavum hematoma. A ligamentum flavum hematoma must always be included in the differential diagnosis of mass lesions of the spinal canal. Thoracolumbar ligamentum flavum hematomas are extremely rare.
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