副鼻腔骨腫に伴った硬膜内粘液囊胞の1例

Intradural Mucocele Associated with a Frontoethmoidal Osteoma:A Case Report

Ⅰ．はじめに

　副鼻腔骨腫は良性腫瘍として知られているが，時に眼窩や頭蓋内へと伸展することがある．また粘液囊胞の形成にも関与し，それが頭蓋底を破壊して頭蓋内へ伸展することもある．特に，硬膜内伸展を来した症例は過去に22例のみの報告しかなく稀であり，未だ治療方針は確立されていない．

　今回筆者らは，副鼻腔骨腫に伴った硬膜内粘液囊胞に対して手術加療を行った症例を経験したので，文献的考察を加えて報告する．

　The formation of symptomatic intradural mucocele associated with a paranasal osteoma is rare, and no standard treatment has been established. Here, we present a case of intradural mucocele in a 27-year-old man complaining of headache and generalized convulsion. Cranial CT and brain MRI showed a left frontoethmoidal osteoma extending into the left anterior cranial fossa and orbit along with a mass in the left frontal lobe. He underwent resection of both intracranial osteomas and the mass through left frontal craniotomy. Histological findings were consistent with a mucocele, and the diagnosis of an intradural mucocele associated with a frontoethmoidal osteoma was confirmed. The postoperative course was uneventful. Although both osteoma and mucocele are benign, they may cause life-threatening symptoms by expanding intracranially. A tailored treatment considering the invasiveness and postoperative long-term follow-up of the patient is essential for this uncommon condition.