―症例―術前照射が著効を呈した髄膜腫の1例

A Case of Hypervascular Meningioma: The effect of preoperative irradiation

I．はじめに

　髄膜腫は放射線感受性に乏しく，extra-axialの良性腫瘍であることから，その治療法としては外科的全摘出が最も理想的であると考えられている^{5,7,8,13,16）}．症例により，術前処置として，栄養血管の結紮や人工塞栓術などが試みられている．今回われわれは血管に富んだ巨大な髄膜腫に対し放射線の術前照射を試みた．照射後，腫瘍の大きさ，血管陰影の著しい縮小を認め，照射14カ月後に神経学的欠落症状をきたすことなく全摘し得た，この症例を紹介し，文献的考察を加える．

A 30-year-old, right handed male was admitted with headache and mild rightsided motor weakness of one year's duration. A CT scan revealed a mass over the left frontal convexity. A cerebral angiogram showed a huge, hypervascular tumor which was fed by bilateral external carotid and left internal carotid arteries. Because of its size and location, a surgical intervention was considered contraindicated at that time. Instead he was initially irradiated 52 Gy in total dose with 10MV x-rays (Linear) . A CT scan 4 month thereafter revealed remarkable decrease in the size of tumor and reduction of its mass effect.