両側高度感音難聴・平衡機能障害をきたした髄膜癌腫症の1例

A case of meningeal carcinomatosis with bilateral sensorineural deafness balance disorder

はじめに

　髄膜癌腫症は，悪性腫瘍が播種性に髄膜に移行・増殖する病態で，多彩な神経症状を呈することが知られている。また進行が早く，予後はきわめて不良である。髄膜癌腫症では種々の脳神経麻痺が出現するが，両側の聴覚障害をきたすことは比較的稀である。今回われわれは，髄膜癌腫症により比較的早い経過で両側感音難聴・平衡機能障害が進行した1例を経験したので，文献的考察を加えて報告する。

　A 70-year-old man receiving chemotherapy at the Department of Respiratory Medicine for lung adenocarcinoma was referred to our department after losing the ability to walk straight. Simple head magnetic resonance imaging（MRI）revealed a mass in the bilateral internal auditory meatus, while a head-enhanced MRI revealed a left trigeminal nerve mass. A diagnosis of meningeal carcinomatosis was made. The patient was hospitalized 3 weeks after his visit to our department, during which time he was not receive chemotherapy. A marked decrease in bilateral hearing was noted. He received intrathecal injections and whole-brain irradiation but died 2 months after admission.