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Neurological Surgery No Shinkei Geka Volume 44, Issue 6 （June 2016）

Neurological Surgery 脳神経外科 44巻6号（2016年6月発行）

Japanese English

症例

Dumbbell型を呈した孤発性胸髄脂肪腫の1例 A Dumbbell-Type Thoracic Spinal Lipoma:A Case Report 高宮宗一朗 ¹ , 飛騨一利 ¹ , 矢野俊介 ¹ , 笹森徹 ² , 関俊隆 ² , 斎藤久寿 ¹ Soichiro TAKAMIYA ¹ , Kazutoshi HIDA ¹ , Shunsuke YANO ¹ , Toru SASAMORI ² , Toshitaka SEKI ² , Hisatoshi SAITO ¹ ¹札幌麻生脳神経外科病院脳神経外科 ²北海道大学大学院医学研究科・医学部脳神経外科 ¹Department of Neurosurgery, Sapporo Azabu Neurosurgical Hospital ²Department of Neurosurgery, Hokkaido University Graduate School of Medicine キーワード： dumbbell , spinal lipoma , tethering Keyword: dumbbell , spinal lipoma , tethering pp.495-499

発行日 2016年6月10日 Published Date 2016/6/10

DOI https://doi.org/10.11477/mf.1436203317

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参考文献 Reference

Ⅰ．はじめに

　脊髄脂肪腫は，全脊髄腫瘍の1%未満と比較的稀な腫瘍である³⁾．その多くは脊椎癒合不全に合併するが，脊椎癒合不全を伴わない孤発例も存在する．孤発性脊髄脂肪腫は，軟膜下脂肪腫が多く，硬膜内外に及ぶいわゆるdumbbell型となることは極めて稀である．今回われわれは，dumbbell型を呈した孤発性胸髄脂肪腫の1例を経験したので，その手術法を含め報告する．

　Spinal lipomas are rare, accounting for less than 1% of all spinal tumors. Most are associated with spinal dysraphism. Spinal lipomas without spinal dysraphism are uncommon;they are typically subpial tumors. Some tumors are located both inside and outside the dura mater（so-called “dumbbell-type”). Herein, we report a patient with a dumbbell-type thoracic spinal lipoma.

　A man in his 50’s complained of progressive gait disturbance, dysesthesia in his left leg, and hyperesthesia in his right leg. His symptoms were worsened by exercise. CT and MRI revealed a thoracic spinal lipoma extending from the spinal cord to the intervertebral foramen at the Th6-8 level. He underwent partial tumor removal and untethering. Postoperatively he reported gradual symptom abatement.

　Dumbbell-type spinal lipomas are very rare. Besides partial removal of the tumor, untethering should be considered when symptoms are associated with tethering of the spinal cord.