肺癌の硬膜転移による硬膜下血腫の1例

A Case of Subdural Hematoma Associated with Dural Metastasis of Lung Cancer

Ⅰ．はじめに

　悪性腫瘍の硬膜転移に伴う硬膜下血腫は極めて稀であり，われわれが渉猟し得た範囲では本例を含めて52例の報告があるのみである⁶⁾．今回われわれは進行した肺癌患者に慢性硬膜下血腫を伴い，術中採取した硬膜，血腫内容から転移性腫瘍が原因の硬膜下血腫と診断し得た1例を経験した．その成因と特徴について，これまでの報告例を含めて検討し報告する．

　A 62-year-old male developed headache, restlessness and left hemiparesis three months after being diagnosed with advanced lung cancer. Computed tomography on admission revealed a crescent-shaped, mixed intensity area in the right fronto-parietal subdural region and multiple tumors in the brain parenchyma. Under a diagnosis of chronic subdural hematoma and multiple brain metastases due to lung carcinoma, burr hole irrigation was performed. Adenocarcinoma cells were found in the dura matter and hematoma.

　Nontraumatic chronic subdural hematoma secondary to dural metastasis is a very rare condition. Only 52 cases of such spontaneous subdural hematoma have been reported. We describe the clinical features and discuss the mechanism referring to the pertinent literature.