治療経過中のCT scanにて頭蓋内に異常低吸収域と石灰化を認めた大脳基底核部germ cell tumorの1例

Disseminated Necrotizing Leukoencephalopathy Accompanied with Multiple Calcium Deposits Following Antineoplastic and Radiation Therapy in a Case with Intracranial Germ Cell Tumor: Computerized tomographical study

　I．はじめに

　近年放射線および化学療法の進歩がみられている反面，これらの治療によりひきおこされる白質変性^1,3,13,18），石灰化^16,17）あるいは脳萎縮^13）等の副次的病態も注目されてきた，特に抗癌剤を局所投与することによりひきおこされるleukoencephalopathyの病態は1975年Ru—binstein^12）の報告を嚆矢に，現在もその増加をみている．著者らは，頭蓋内germ cell tumorの放射線および化学療法の経過中に，経時的なCT scanにて異常低吸収域と石灰化を認めた症例を経験したので石灰化形成過程等の病態について若干の文献的考察を加え報告する．

A form of disseminated necrotizing leukoencephalo-pathy and the shaping process of calcification was observed by CT scan in a 9-year-old boy with intracra-nial germ cell tumor who had received systemic com-bined chemotherapy, brain radiation, and intraventricu-lar administration of methotrexate and bleomycin for the meningeal involvement of tumor cells.

He was admitted to our hospital complaining of hemiparesis and gait instability. Hormonal examination revealed abnormality of high serum HCG and testoster-one. An initial CT scan showed a ring enhancing lesion in the right side of the caudate head.