びまん性上衣下転移を来した肺small cell carcinomaの極めて稀な1症例

A Very Rare Case of Diffuse Subependymal Metastases from Small Cell Lung Carcinoma

Ⅰ．はじめに

　転移性脳腫瘍の原発巣は肺癌が最も多く，発生部位としては前頭葉，小脳，頭頂葉など，一般的には脳実質内がほとんどであり脳室内への転移は比較的稀である¹⁾．脳室内転移における原疾患としては癌腫，悪性リンパ腫，メラノーマなどの報告があるが，最も多いのは腎細胞癌からの転移であると言われている^{2-5,7,9,11,12)}．

　今回われわれは，びまん性に全脳室壁に転移を来した肺small cell carcinomaの極めて稀な症例を経験したので，文献的な考察を加え報告する．

　While parenchymal metastases are common in solid systemic cancers, subependymal metastases are rare. Approximately half of the reported cases of intraventricular metastases originate from renal carcinoma.

　A 65-year-old man presented with general fatigue, appetite loss, nausea, and disorientation. Radiological examination revealed diffuse periventricular tumors. The patient underwent an open biopsy via right frontotemporal craniotomy. The patient was diagnosed with metastatic small cell lung carcinoma after histopathological examination.

　Although subependymal metastases from solid systemic cancer are very rare, this ventricular wall abnormality in the cancer patients must not be overlooked. Many small subependymal metastases might be missed on routine examination.