多発性頭蓋外転移により低血糖発作を併発したMeningeal Hemangiopericytomaの1例

Multiple Extracranial Metastases from a Meningeal Hemangiopericytoma and Severe Hypoglycemia : A Case Report

　Ⅰ．はじめに

Meningeal hemangiopericytomaは全脳腫瘍の0.2％と稀な腫瘍であり，主として中年成人にみられ，大脳半球の硬膜や硬膜洞静脈洞壁に接して発生し，malignant meningiomaとの鑑別が困難なことが多い．そして，しばしば肺臓，脊椎，肝臓等に転移することは，良く知られている．今回われわれは肝臓，腰椎，右大腿骨に転移して，著明な低血糖発作を発症し，グルカゴン持続投与を必要としたmeningeal hemangiopericytomaの1例を紹介する．

　Extracranial multiple metastases from meningeal hemangiopericytoma have been reported only rarely. The authors describe the case of a 61-year-old woman,who was previously diagnosed as having primary meningeal hemangiopericytoma with its multiple metastases to the liver,lumbar spine,etc. and who suffered from a sudden attack of hypoglycemia. Considering the history of her present illness,this hypoglycemic shock was most likely brought on by the remarkable metastatic tumors to the liver. Recent literature pertinent to hypoglycemia suggests that insulin-like growth factor-II (IGF-II) produced by tumor is strongly suspected to be involved in the development of hypoglycemia.