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Neurological Surgery No Shinkei Geka Volume 20, Issue 9 （September 1992）

Neurological Surgery 脳神経外科 20巻9号（1992年9月発行）

Japanese English

症例

胸腔内髄膜瘤の4例 A Report of Four Cases of Intrathoracic Meningocele 渋谷誠 ^1,3 , 御子柴雅彦 ¹ , 池田譲治 ¹ , 伊東良則 ² , 三輪哲郎 ² Makoto SHIBUYA ^1,3 , Masahiko MIKOSHIBA ¹ , Joji IKEDA ¹ , Yoshinori ITO ² , Tetsuro Miwa ² ¹東京医科大学脳神経外科 ²東京医科大学霞が浦病院脳神経外科 ³カリフォルニア大学サンフランシスコ校脳神経外科 ¹Department of Neurosurgery, Tokyo Medical College ²Department of Neurosurgery, Tokyo Medical College Kasumigaura Hospital ³Department of Neurological Surgery, University California, San Francisco キーワード： Intrathorax , Meningocele , von Recklinghausen's disease Keyword: Intrathorax , Meningocele , von Recklinghausen's disease pp.979-983

発行日 1992年9月10日 Published Date 1992/9/10

DOI https://doi.org/10.11477/mf.1436900523

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Abstract 文献概要
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I．はじめに

　胸腔内髄膜瘤は稀な疾患であり，1933年pohl^14）により初めて報告され，1986年，Maiuriら^7）の報告までに95例の記載があるのみで，本邦では，1957年丸岡ら8）の報告以来21例の記載があるにすぎない^{5,6,10,11,17）}．今回われわれは，1966年より20年間に4例の胸腔内髄膜瘤を経験したので，文献的考察を含めて報告する．

Intrathoracic meningocele is regarded as an uncommon pathological entity frequently associated with von Recklinghausen's disease. In this paper, four cases of intrathoracic meningocele, treated between 1966 and 1986, are presented. There were three males and one female, all between the ages of 40 and 50. These were referred to our clinic for further evaluation of an asymptomatic lesion which had been seen on a routine chest roentgenogram. There was definite evidence ofvon Recklinghausen's disease in three cases : two males and one female. All four cases had no pain, dys-pnea or neurological disorder. Chest and vertebral tomo-grams revealed masses in the posterior mecliastinum and enlarged vertebral canals at the location of the le-sion which varied from T-3 to T-11 ; three on the left side and one on the right side. None of them revealed scoliosis or kyphosis of the spine. In three cases, myelography was performed and showed an egg-shap-ed mass dorsolateraly. In two cases, metrizamide com-puted tomographic myelography was carried out and demonstrated deformity of the vertebral bone and pas-sage of the contrast material through the enlarged ver-tebral canal into the paravertebral mass.

Furthermore, magnetic resonance imaging was per-formed in two cases, and showed a homogeneous low signal intensity paravertebral mass communicating with the spinal canal on TI-weighted image. In two cases, the meningoceles were ligated or wrapped surgically. Postoperatively one presented a paraparesis and severe meningitis, and died ; the other had an uneventful post-operative course. Two patients were followed con-servatively without developing any symptoms or signs. In this paper, four cases of asymptomatic intrathoracic meningocele seen during the past 20 years, and etiologi-cal and therapeutic considerations are discussed.