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Neurological Surgery No Shinkei Geka Volume 18, Issue 12 （December 1990）

Neurological Surgery 脳神経外科 18巻12号（1990年12月発行）

Japanese English

症例

馬尾神経に発生した転移性Grawitz腫瘍の1例 Metastatic Grawitz's Tumor to the Cauda Equina: Case report 高橋功 ^1,5 , 井須豊彦 ¹ , 岩崎喜信 ¹ , 秋野実 ¹ , 高橋明弘 ¹ , 阿部弘 ¹ , 北川まゆみ ² , 小島英明 ³ , 井上和秋 ³ , 斎藤久寿 ⁴ Isao TAKAHASHI ^1,5 , Toyohiko ISU ¹ , Yoshinobu IWASAKI ¹ , Minoru AKINO ¹ , Akihiro TAKAHASHI ¹ , Hiroshi ABE ¹ , Mayuimi KITAGAWA ² , Hideaki KOJIMA ³ , Kazuaki INOUE ³ , Hisatoshi SAITOH ⁴ ¹北海道大学脳神経外科 ²北海道大学神経内科 ³北海道大学病理部 ⁴札幌麻生脳神経外科病院 ⁵旭川赤十字病院脳神経外科 ¹Departments of Neurosurgery, Hokkaido University, School of Medicine ²Departments of Neurology, Hokkaido University, School of Medicine ³Departments of Pathology, Hokkaido University, School of Medicine ⁴Sapporo Azabu Neurosurgical Hospital キーワード： Cauda equina , Metastatic tumor , Grawitz's tumor Keyword: Cauda equina , Metastatic tumor , Grawitz's tumor pp.1157-1160

発行日 1990年12月10日 Published Date 1990/12/10

DOI https://doi.org/10.11477/mf.1436900185

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Abstract 文献概要
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I．はじめに

　馬尾神経腫瘍の多くは原発性腫瘍であり転移性腫瘍は極めて稀である．文献的に渉猟し得た限りでは7例の報告をみるのみであり^3,4,10,11），Grawitz腫瘍による転移例の報告はない．今回，われわれは馬尾神経に発生した転移性Grawitz腫瘍の1例を経験したので症例を供覧するとともに若干の文献的考察を加えて報告する．

A case of Grawitz's tumor metastasizing to the cauda equina is presented. A 51-year-old male was hospital-ized due to severe low back pain radiating to the left lower extremity. Neurological examination showed only hyporeflexia of the left pattela reflex and positive Lase-goe's sign. MRI showed intradural mass at the 1.4 level.

Preoperatively, we diagnosed a cauda equina tumor. A laminectomy of both L3 and IA was performed, and total removal of the cauda eqina tumor was performed. Microscopically, the tumor cells were large, the appear-ance of the cytoplasm ranging from optically clear with sharply outlined boundaries, to deeply granular, with many transitional forms. These histological findings were typical findings of Grawitz's tumor, and were the same as those of this patient's renal tumor. Finally, we diagnosed Grawitz's tumor metastasizing to the cauda equina. Metastatic cauda equina tumor from outside the central nervous system is very rare and only 7 cases have been reported. This case is the first one of Gra-witz's tumor spreadine to the cauda equina.