後頭蓋窩出血で発症し死亡した斜台部脊索腫の1症例

A Case of Clivus Chordoma Showing Hemorrhage in the Posterior Fossa

I．はじめに

　頭蓋内脊索腫は，頭蓋底部に好発し，周囲の組織を圧迫しながら骨に浸潤，破壊しつつ，緩徐に発育するのを特徴とする．また，病理組織学的に腫瘍内出血をしばしばみるものの，臨床的には急激な症状の変化をおこしたり，致命的となる腫瘍出血を認めることは稀である．今回，われわれは，発症以前には全く症状を呈さず，脳卒中様の急激な発症で来院し，短時間にて死亡した斜台部脊索腫の腫瘍出血例を経験したので，文献的考察を加えて報告する．

We are reporting a rare case of clivus chordoma with fatal hemorrhage in the posterior fossa.

A 38-year-old woman afflicted with sudden onset of severe headache and vomiting. On neurological ex-amination, she was mildly lethargic. She had slight dysarthria and nystagmus, but no cranial nerve abnor-malities. Craniogram revealed erosive changes in the right petrous bone. CT scan showed a massive in-tracerebellar hemorrhage and isodense mass in the sphenoid sinus, which were not enhanced by contrast medium. She became comatose and died 3 days later. No operation was performed.