髄液細胞診で診断された髄腔内播種性多発性髄膜腫の1例

Intrathecal Dissemination of Meningiomas;A case report

I．はじめに

　髄膜腫は，一般に硬膜に付着部を有する単発性の髄外腫瘍で，生物学的には良性な腫瘍である．しかしながら，きわめて稀に脳脊髄液を介して髄液腔内に播種したりあるいは血行性に神経管外に遠隔転移を来たす症例が報告される^1,3,5,8）．最近われわれは，下垂体腺腫に合併して後頭蓋窩と脊椎管内に多発性腫瘍が認められ，髄液細胞診にて髄膜腫の髄腔内手番種と診断された1例を経験したので若干の文献的考察を加えて報告する．

A case of the cytologically verified intrathecal dis-semination of benign meningiomas was reported. A 36-year-old man was admitted to our hospital because trans-sphenoidal surgery was planned for the repair of CSF rhinorrhea caused by a recurrent pituitary adeno-ma. The CT scan demonstrated incidental multiple tumors spread throughout in the pontomedullary and ambient cisterns. The head and spinal MRI showed more than fifteen small tumors in the posterior fossa and the thoracic spinal canal. CSF cytology revealed benign fibroblastic or meningotheliomatous meningi-oma with whorl formation and psammoma body. Sever-al comments were made on the mechanism of the in-trathecal dissemination of the meningiomas.