腫瘍内出血にて発症したseptum pellucidum subependymomaの稀な1症例

A Rare Case of Subependymoma of the Septum Pellucidum as Intratumoral Hemorrhage

Ⅰ．はじめに

　上衣下腫（subependymoma：SE）は脳室壁近傍に発生する分化型の予後良好な神経膠腫である．発生部位としては第四脳室が最も多く，次いで側脳室に好発する^1,6,10,12)．無症候性あるいは剖検などで偶然発見される場合が多く，腫瘍自体の発育も比較的ゆっくりであるため症候性となるものは比較的少ない．また，本来血管性に乏しい腫瘍でもあり出血を来すことは極めて稀である．今回われわれは，透明中隔部の腫瘍内出血を来した症候性SEの極めて稀な症例を経験したので文献的考察を加えて報告する．

　Subependymomas（SEs）are rare, benign, noninvasive, slow-growing tumors located anywhere along the ventricular walls. They arise most frequently in the fourth ventricle followed by the lateral ventricle, and less frequently in the septum pellucidum, third ventricle, and spinal cord. Most SEs are found incidentally at autopsy, but some may produce clinical symptoms. Tumor-related hemorrhage represents an extremely rare presentation sign. We describe a rare case of septum pellucidum SE as tumoral hemorrhage. The tumor was totally removed via an interhemispheric transcallosal approach. Histological examination found typical SE. Although the patient had transient memory impairment, he had a good postoperative course and was discharged on the twenty-first postoperative day.