側脳室・小脳橋角部に同時にみつかった悪性脈絡叢乳頭腫の1成人例

An Adult Case of Malignant Choroid Plexus Papilloma in the Lateral Ventricle and the Cerebellopontine Angle Revealed Simultaneously

I．はじめに

　Chorold Plexus Papillomaは原発性脳腫瘍の0.4—0.6％^1,10,19）で比較的少ない腫瘍であり，しかも悪性像を呈するものは，極めて稀である．いずれも小児に発生することが多いが，今回われわれは，右側脳室三角部と左小脳橋角部に，初診時に，同時に見つかったmalignantchoroid plexus papillomaの1成人例を経験したので報告する．

An adult case of malignant choroid plexus papilloma is very rare. This report is an adult case of malignant choroid plexus papilloma revealed in the lateral ven-tricle and in the cerebellopontine (CP) angle simul-taneously.

A 37-year-old man was admitted to the hospital com-plaining of headache, nausea, and a floating sensation on August 29, 1984. Neurological examination on admission revealed bilateral papilledema, left clysmetria and horizontal nystagmus.CT scan revealed a slightly high density round mass in the right lateral ventricle and a cystic mass with mural nodule in the left CP angle. The intraventricular mass and mural nodule were enhanced moderately and homogeneously. The initial surgery was for removal of the CP angle tumor, and 8 days later removal of the lateral ventricle tumor was carried out. The histology of these tumors was the same and revealed malignant choroid plexus papilloma. Postoperative radiation therapy was carried out 70Gy to the brain (whole brain; 50Gy, focal; 20Gy) and 30Gy to the whole spine. About 2 years later parapare-sis, lower cranial nerve palsy, and disturbance of con-sciousness had progressed gradually. He died of the se-vere recurrence of the tumor in the brain stem, and multiple dissemination in the spinal cord on September 6, 1987. There was no recurrence of tumor in the right lateral ventricle.