5FU誘導体に起因すると思われるToxic leucoencephalopathyの1例

A Case of Toxic Leucoencephalopathy induced by 5 FU Derivative

I．はじめに

　近年CTなど診断技術の進歩に伴い転移性脳腫瘍を手術する機会が増加している．これら治療に伴い，放射線療法のみならずさまざまな化学療法が試みられている．最近われわれは乳癌治療中に多彩な神経症状を呈し，転移性脳腫瘍と誤診し，後日，剖検にて5FU誘導体（tegafur,carmofur）に起因すると思われるtoxic leuco-encephalopathyの1例を経験した．癌の治療中，神経症状がみられた場合，脳外科医は転移性脳腫瘍を中心に診断をすすめ，薬剤に起因する症状は盲点になりやすい．そこでわれわれが経験した1症例を呈示し，注意を喚起するとともに，文献的考察を加え，抗癌剤により白質変性症について診断，病理所見を中心に述べていきたい．

A case of toxic leucoencephalopathy induced by 5 FU derivatives is reported.

A 46-year-old woman was diagnosed as having breast cancer, and radical mastectomy was performed on May, 1982. After operation, she was given irra-diation and 5 FU derivative (tegafur or carmofur) 600 mg and Nolvadex 20 mg (tamoxifen citrate) were administered every day. After taking the medication for a month, she began to stagger and developed a tremor in both arms. She was admitted to our hos-pital on August 16, because she showed evidence of dysarthria and memory disturbance in addition to her initial complaints.