131I-MIBGシンチが局在診断に有効であつた新生児神経芽細胞腫

A CASE OF NEONATAL NEUROBLASTOMA-SPECIAL REFERENCES TO 131I-MIBG SCINTIGRAM IN DIAGNOSIS OF PRIMARY SITE

　症例は上腹部腫瘤（肝腫大）と尿中カテコラミン陽性所見より神経芽細胞腫が疑われた生後2日の男児。CTスキャンなどで明らかな原発巣不明のためMIBGスキャン施行。左副腎部に集積を認めた。試験開腹による病理所見で副腎にinsitu様病変と肝転移が認められIV-S期と診断した。術後化学療法を施行したが自然治癒の可能性から中止した。以後，肝は縮小し尿中カテコラミンは正常化した。現在生後6ヵ月を過ぎ順調に発育している。

A two-day-old male infant was referred to us for probable neuroblastoma, because of upper abdominal mass and positive urinary vanillylmandelic acid (VMA). Primary site of neuroblastoma was not found, but clinically IV-S stage neuroblastoma was strongly suspected, so ¹³¹I-metaiodobenzylguanidine (MIBG) scan was performed. RI accumulation was found near the left adrenal region. Thus laparotomy was performed and left adrenal was resected. Liver biopsy was also performed. Microscopically multiple in situ foci of neuroblastoma cells were found in the left adrenal and tumor involvement was also seen in the liver.