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Neurological Surgery No Shinkei Geka Volume 19, Issue 3 （March 1991）

Neurological Surgery 脳神経外科 19巻3号（1991年3月発行）

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Radiation Induced Gliosarcomaの2例 Two Autopsied Cases of Radiation Induced Gliosarcoma 川口進 ¹ , 柏葉武 ¹ , 小岩光行 ¹ , 下山三夫 ¹ , 小林延光 ¹ , 福士幸彦 ¹ , 徳田耕一 ² Susumu KAWAGUCHI ¹ , Takeshi KASHIWABA ¹ , Mituyuki KOIWA ¹ , Mituo SHIMOYAMA ¹ , Nobuaki KOBAYASHI ¹ , Yukihiko FUKUSHI ¹ , Kouichi TOKUDA ² ¹柏葉脳・神経外科病院 ²北海道大学脳神経外科 ¹Kashiwaba Neurosurgical Hospital ²Department of Neurosurgery, Hokkaido University School of Medicine キーワード： Gliosarcoma , Radiation therapy , Radiation induced tumor Keyword: Gliosarcoma , Radiation therapy , Radiation induced tumor pp.285-290

発行日 1991年3月10日 Published Date 1991/3/10

DOI https://doi.org/10.11477/mf.1436900236

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Abstract 文献概要
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I．はじめに

　脳腫瘍に対する放射線治療の後に一定の潜伏期間をおいて，同一照射野に組織的に異なる腫瘍が新たに発生することは放射線誘発腫瘍として時折みられ，頭蓋内ではsarcoma，meningiomaが多く，gliomaは稀であるといわれている．又，gliosarcomaはgliomaと間質系のsar—comaのmixed tumorとしてStrobe（1895）により報告され，その後欧米では100例以上の報告がみられるが本邦ではこれまで10例の報告をみるのみである．今回われわれは脳腫瘍の放射線治療後に発生したgliosarcomaの2例を経験したので若干の文献的考察を加え報告する．

Abstract

Two autopsied cases of radiation induced gliosarco-ma are presented in detail with a review of the literatu-res.

Case 1 was that of a 36-year-old female who was found to have a metastic choriocarcinoma in the right occipital lobe and received radiation therapy of 45 Gy. Four years later CT scan showed a new enhanced tumor in the cerebellum within the previously irradia-ted field. Total removal was performed and histological diagnosis of the tumor was a gliosarcoma. She died 12 months after the operation.

Case 2 was that of a 63-year-old male who had a pro-toplasmic astrocytoma in the left temporal lobe and re-ceived radiation therapy of 60 Gy after surgery. The tumor recurred in the left temporal base after 9 years. Histological finding of the surgical specimens showed gliosarcoma. The patient died 2 months after he was operated on. The tumors had obviously two defined neoplastic components. One was gliomatous features with anaplastic glial cells which stained for glial fibril-lary acidic protein. The other was malignant mesenchy-mal features with spindle shaped fibrosarcoma cells which contained numerous reticulin fibers. Postmortem examination revealed these similar features. Criteria for identifying a tumor as a radiation in-duced neoplasm have been proposed by Fajado. The main criterion is that the induced tumor should occur in the previously irradiated field. Secondly, it should appear after a latent period. Thirdly, the pathology should be different from the initial neoplasm. Our cases fulfil these criteria. These two malignant tumors occur-red after irradiation and were highly suspected to be radiation-induced neoplasms. This report is thought to be the first report of radiation-induced gliosarcoma.