髄膜播腫を来した前立腺横紋筋肉腫

DIFFUSE MENINGEAL SARCOMATOSIS FROM RHABDOMYOSARCOMA OF THE PROSTATE: A CASE REPORT

　48歳，男性。前立腺横紋筋肉種の傍大動脈リンパ節再発に対して，CBDCA,VP-16,ADM，CPMによる多剤併用療法を施行した。腫瘤は著明に縮小した。3コース目の薬剤投与終了頃より頭痛，軽い失見当識を認めるようになった。髄液細胞診，造影MRIにて髄膜播種と診断された。LPシャントを施行し，脳圧亢進症状は改善した。CDDPの髄腔内投与を試みたが，痙攣発作が重積するようになり死亡した。

A 48-year old male with meningeal sarcomatosis from rhabdomyosarcoma of the prostate was presented. Three months after irradiation (62 Gy) and three courses of CYVADIC, he started to complain lumbar dull pain. On admission, paraaortic lymphnodes metastasis were also noted. He was treated with modified ACEP (ADR, CPM, VP-16 and CBDCA) and abdominal mass was remarkably reduced. But, he developed headache and slight dementia. Cerebro-spinal cytology revealed malignant sarcoma cells. The Gd-enhanced MRI also showed meningeal dissemination. He was treated with intra-cranial CDDP administration, but died 3 days later