全脳室壁へ播種したgerminomaの1例

A Case of Entire Ventricular Dissemination of Germinoma

Ⅰ．はじめに

　松果体部あるいはトルコ鞍近傍から発生するgerminoma（いわゆるtwo-cell pattern pinealoma）は，第3脳室，脊髄くも膜下腔へしばしば播種転移するが，全脳室系へびまん性に播種することはあまりない．われわれが調べた範囲ではいままでに37例報告されているが，これらのほとんどが剖検により初めて全脳室壁への播種が確認されたものである．今回われわれは，生前，臨床経過および臨床検査によって，鞍上部から発生したと思われるgerminomaの全脳室壁への播種浸潤を診断し得た症例を経験したので報告する．

Although it is well known that germinomas (so-called two-cell pattern pinealoma) infiltrate the adjacent structures or the wall of the third ventricle, the involvement of all the ventricles by the tumor is not frequent. To the authors' knowledge, 37 cases have been previously reported, in almost all of which the entire ventricular dissemination was proved no more than by necropsy. In other words, its clinical diagnosis was difficult. We experienced a case of germinoma which disseminated into all the ventricles and exhibited unique CT scans.