Medulloblastomaの腫瘍内出血の1例

A Case of Massive Fatal Hemorrhage in a Recurrent Medulloblastoma during Radiotherapy

I．はじめに

　脳腫瘍由来の頭蓋内出血に関しては少なからず報告がみられ，悪性度の高い腫瘍あるいは異常血管に富む腫瘍ほどその頻度は高い傾向がみられるとされている．しかし，medulloblastomaは小児脳腫瘍中，最も悪性度の高い腫瘍でありながら腫瘍内出血の報告は少ない，今回，著者らは治療中，腫瘍内出血により急激に症状が悪化し，死の転帰をとったmedulloblastomaの1症例を経験したので文献的考察を加えて報告する．

A medulloblastma in a 7-year-old girl showed com-plete remission after the initial radiotherapy of 5,000 rad. But she had three episodes of recurrence in the cerebellum and in the spinal cord, and was treated by additional radiotherapy for the lesions 3,000 to 5,000 rad. When the total cerebellar tumor dose became 13,300 rad, a fatal intratumoral hemorrhage occurred.

Autopsy revealed a massive intratumoral hematoma and thin-walled tumor vessels which might be desig-nated as "sinusoid" or "telangiectasia" microscopi-cally.