脊髄Melanotic schwannomaの1例

Spinal Melanotic Schwannoma: Report of a case

I．はじめに

　神経系に発生するpigmented tumorの多くは原発性及び転移性黒色腫であるが，稀にメラニン色素を腫瘍内に含むいわゆるmelanotic variants of certain types oftumors^8,11）として，melanotic meningioma^8,11），melano—tic medulloblastoma^8,11），pigmented neuroectodermaltumor of infancy^25），melanotic schwannoma^{2,4,16,19,22）}などが報告されている．このうち，melanotic schwan—nomaは，末梢神経や神経節由来の皮膚，軟部組織腫瘍として知られ^{3,6,10,14,24）}、しばしば悪性の経過をたどり悪性黒色腫などとの鑑別が問題とされるが^6），頭蓋内や脊柱管内に発生した症例の報告は少ない．

　われわれは，下位胸椎椎管内外にdumbbell状に発育伸展したmelanotic schwannomaの1例を経験したので文献的考察を加え報告する．

A case of spinal dumbbell shaped melanotic schwan-noma was reported. A 58-year-old housewife had a 3-months history of progressive gait disturbance. She also complained of mild backache and numbness in both legs. Her family history was not remarkable.When examined on admission, October 10 1982, mild weakness of both legs with spasticity and sensory im-pairment below the level of T10 dermatome without sacral sparing were evident. Her deep tendon reflexes were hyperactive on both sides and plantar responses were extensor bilaterally. Sphincteric disturbance was not significant. The function of her cranial nerves was intact.