骨破壊を伴わない脊椎硬膜外腫瘍の検討

Spinal Epidural Tumors without Destructive Bone Change: Clinical and radiological studies

I．はじめに

　脊椎硬膜外腫瘍の多くは，転移性脊椎腫瘍の硬膜外伸展であり，脊椎単純撮影による骨破壊像の検索が重要とされている．又，神経鞘腫などの原発性腫瘍では，殆どが骨のpressure erosionを伴う^8）．しかし骨破壊やero—sionを欠く硬膜外腫瘍の正確な報告はない．著者らは最近このような硬膜外腫瘍が，少なからず存在する事に気付いた．骨変化のない硬膜外腫瘍の場合，しばしば診断に苦慮する．今回，このような骨破壊のない硬膜外腫瘍症例の臨床，組織及び放射線学的診断について検討したので報告する．

CT in 61 patients having spinal epidural tumors were reviewed. Of these patients twelve had an epidu-ral mass lacking of destructive bone change. Histologic-al examination of these 12 cases revealed that usual carcinomatous tumors are relatively less common but sarcomatous tumors and malignant hematologic neo-plasms are more likely to form an epidural mass with-out bone destruction. The tumors preponderated thor-acic spine and extended usually more than three spinal levels along spinal axis. In all but one tumor masses were found in the intersertebral foramen and the para-spinal region in addition to the spinal canal.