両側聴神経転移による難聴で発症した髄膜癌腫症の1剖検例

A Case of Meningeal Carcinomatosis Presenting with Bilateral Hearing Loss

はじめに

　髄膜癌腫症は担癌患者の4～5％にみられ，その原発巣としては，固形癌では肺癌，乳癌，悪性黒色腫などに多いとされる^1）。髄膜癌腫症で障害される脳神経は視神経，外転神経，動眼神経，顔面神経に多いと報告されている^2）。一般に，既に悪性腫瘍の診断がついた患者に起こるが，稀に脳神経症状が初発となることもある。われわれは，蝸牛症状で発症し両側第Ⅶ・Ⅷ脳神経に転移塊を形成した，胃低分化腺癌の1剖検例を経験したので報告する。

Abstract

　We report the case of a 63-year-old male who developed rapidly progressive bilateral deafness.　Two months later he became stuporous, and was transferred to our hospital.　The patient's MRI demonstrated bilateral hypertrophic VII・VIII cranial nerve roots that were well enhanced.　Gradually, the patient's condition worsened, and he died on the 12th day after admission.　Autopsy revealed meningeal carcinomatosis with poorly differentiated gastric adenocarcinoma.　White firm masses of the bilateral seventh and eighth bilateral cranial nerve roots were found at autopsy, which were found to be metastases of the gastric cancer cells as well.　Metastatic tumors can be take into consideration as a differential diagnosis for bilateral-enhanced eighth cranial nerve root masses.