Garcin症候群を呈し，放射線療法が著効を示した悪性髄膜腫の1例

Radiosensitive Malignant Meningioma Presenting Garcin's Syndrome:A case report

I．はじめに

　Garcin症候群とは，脳病巣症状や頭蓋内圧亢進症状を伴わずに，一側の全部あるいは大多数の脳神経麻痺を示す症候群で，通常X線写真上頭蓋底部に骨破壊像を認めるものである．その原因疾患として，原発性脳腫瘍では脊索腫，頭蓋咽頭腫によるものが報告されている．

　今回われわれは悪性髄膜腫によりGarcin症候群を呈し，放射線療法が著効を示した症例を経験したので文献的考察を加えて報告する．

A 58-year-old woman with Garcin's syndrome caused by malignant meningioma is reported. She first noticed left facial hypesthesia followed by left visual disturb-ance with exophthalmos. CT scan showed an enhanced mass extending from the left cavernous sinus to the left orbit. Cranial x-ray revealed bone deformity around the orbit. The tumor was subtotally resected and its histo-logical type was shown to be anaplastic meningioma. After the initial surgery the patient was left with hyposmia, mild ptosis and incomplete 6th cranial nerve palsy on the left side. After one and half years, not only palsy of those cranial nerves but also that of other unilateral cranial nerves became progressively apparent due to tumor regrowth. In total, 11 nerves (2nd-12th) were affected by the tumor, without long tract signs or symptoms of increased intracranial pressure. Radiation therapy carried out after the 2nd surgery was extreme-ly effective and resulted in the recovery of lower cra-nial nerve function. The tumor was founded to have disappeared completely on the 2-year follow-up CT.