尿失禁で発症した脊髄脂肪腫の1成人例

An Adult Case of Intradural Lumbo-sacral Lipoma

I．はじめに

　脊髄脂肪腫は全脊髄腫瘍の約1％を占める．大多数はspinal dysraphismの一型として，小児期に発症する．われわれは，成人期に尿失禁で発症した脊髄脂肪腫の1例を経験したので報告する．

A rare case of lumbo-sacral lipoma in an adult case is reported. A 55-year-old male was admitted to the Depart-ment of Neurosurgery, Mazda Hospital, after a history of one year of urinary incontinence. Neurologically, no motor or sensory disturbance of the lower extremities was found in this patient. MRI showed a mass with high signal intensity on T2-weighted image, located between L3 to S2 vertebral segments. Metrizamide-CT scan de-monstrated the outline of this hypodense mass at the same location as shown on MRI image.

A L3 through L5 laminectomy was performed and the tumor was subtotally removed. Microscopic examination revealed that the tumor mass was made up of mature lipoma cells. Postoperative course of the patient was un-eventful. The urinary incontinence was improved slight-ly. No motor or sensory deficit was found.

We thought that MRI was useful for the correct dia-gnosis of lumbosacral lipoma. And it is best managed by operative removal of the tumor as early as possible af-ter it is diagnosed.