雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

Neurological Surgery No Shinkei Geka Volume 46, Issue 12 （December 2018）

Neurological Surgery 脳神経外科 46巻12号（2018年12月発行）

Japanese English

症例

腫瘍内出血を来したdiffuse astrocytoma with pilomyxoid featuresの1例 Diffuse Astrocytoma with Pilomyxoid Features Presenting as Intratumoral Hemorrhage:A Case Report 松浦知恵 ¹ , 栄山雄紀 ¹ , 野手康宏 ¹ , 上田啓太 ¹ , 安藤俊平 ¹ , 桝田博之 ¹ , 近藤康介 ¹ , 原田直幸 ¹ , 根本匡章 ¹ , 周郷延雄 ¹ Chie MATSUURA ¹ , Yuuki SAKAEYAMA ¹ , Yasuhiro NODE ¹ , Keita UEDA ¹ , Shunpei ANDO ¹ , Hiroyuki MASUDA ¹ , Kosuke KONDO ¹ , Naoyuki HARADA ¹ , Masaaki NEMOTO ¹ , Nobuo SUGO ¹ ¹東邦大学医学部医学科脳神経外科学講座（大森） ¹Department of Neurosurgery（Omori), School of Medicine, Faculty of Medicine, Toho University キーワード： low grade glioma , intratumoral hemorrhage , diffuse astrocytoma with pilomyxoid features , arteriovenous shunt Keyword: low grade glioma , intratumoral hemorrhage , diffuse astrocytoma with pilomyxoid features , arteriovenous shunt pp.1073-1079

発行日 2018年12月10日 Published Date 2018/12/10

DOI https://doi.org/10.11477/mf.1436203870

PDF(3177KB)

有料閲覧

Abstract 文献概要
1ページ目 Look Inside
参考文献 Reference

Ⅰ．はじめに

　脳腫瘍で腫瘍内出血を来す頻度は0.6〜14.6%とされ，出血を来しやすいのは一般的に転移性脳腫瘍や膠芽腫などの悪性脳腫瘍である²¹⁾．腫瘍内出血の頻度は，転移性脳腫瘍では2.9〜14%で，原疾患として，肺癌，悪性黒色腫，絨毛癌，甲状腺癌が多い¹⁶⁾．また，原発性脳腫瘍である神経膠腫では3.7〜7.2%の頻度であり，膠芽腫の頻度が最も高く，low grade glioma（LGG）は1%未満と稀である^1,5,10,15)．今回われわれは，腫瘍内出血で発症し，脳血管撮影において動静脈短絡を呈したdiffuse astrocytomaの1例を経験したので報告する．

　Hemorrhagic low-grade glioma（LGG）without malignant transformation is rare, accounting for less than 1% of cases. To the best of our knowledge, hemorrhagic LGG with an arteriovenous（AV）shunt has not been reported. We report the case of 17-year-old man with LGG with an AV shunt. He presented to our hospital with seizure. Computed tomography（CT）demonstrated a hypodense lesion with mass effect in the right frontal lobe. T1-weighted images（WI）and T2WI on magnetic resonance imaging（MRI）revealed acute-onset hemorrhage in the right frontal lobe. Furthermore, a ring-enhancing lesion was noted on gadolinium（Gd）-DTPA T1WI, and an AV shunt was found in the same region on angiography. Gross total tumor resection was performed. The pathological diagnosis was diffuse astrocytoma with pilomyxoid features（WHO grade Ⅱ). Without adjuvant therapy, no residual tumor was found on MRI at the 6-year follow-up examination. We treated a case of hemorrhagic LGG with an AV shunt. Intratumoral hemorrhage in LGG may occur and should be considered for the differential diagnosis.