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Neurological Surgery No Shinkei Geka Volume 21, Issue 1 （January 1993）

Neurological Surgery 脳神経外科 21巻1号（1993年1月発行）

Japanese English

症例

胸髄部多発性髄膜腫の2例 Multiple Meningiomas of Thoracic Spinal Cord: Report of two cases 牧内恒生 ^1,2 , 近藤達也 ¹ , 篠浦伸禎 ¹ , 山川健太 ¹ , 小井戸隆 ¹ Tsuneo MAKIUCHI ^1,2 , Tatsuya KONDO ¹ , Nobusada SHINOURA ¹ , Kenta YAMAKAWA ¹ , Takashi KOIDO ¹ ¹国立病院医療センター脳神経外科 ²鹿児島大学脳神経外科 ¹Department of Neurosurgery, National Medical Center キーワード： Spinal meningioma , Multiple tumors , Magnetic resonance imaging , CT Myelography Keyword: Spinal meningioma , Multiple tumors , Magnetic resonance imaging , CT Myelography pp.89-93

発行日 1993年1月10日 Published Date 1993/1/10

DOI https://doi.org/10.11477/mf.1436900592

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Abstract 文献概要
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I．はじめに

　脊髄の多発性腫瘍は文献的に散見されるが，ほとんどは神経鞘腫や神経線維腫であり，髄膜腫は稀である．われわれは最近胸髄都に多発した髄膜腫の2症例を経験したので，文献的考察を加えて報告する．

Multiple spinal meningiomas are relatively rare and account for from only 2 to 3.5% of all spinal menin-giomas. Two cases of multiple meningiomas of the tho-racic spinal cord were reported.

Case 1. A 73-year-old woman was admitted with a 5 month history of progressive motor weakness and sen-sory disturbance in the legs bilaterally. Neurological findings on admission revealed paraparesis, hypesthesia and hypalgesia under the Th10 level, hyperreflexia of both legs, and urinary incontinence. Myelography and MRI revealed two intradural extrameclullary lesions at the Th7 and Th10 level.

Both tumors were removed completely. Histopatholo-gical examination showed psammomatous meningiomas. Case 2. A 52-year-old man was admitted with a 2 month history of progressive motor weakness and numb-ness of both legs. Neurological findings on admission re-vealed oaraoaresis, hvoesthesia and hypalgesia under the Th10 level, hyperreflexia of both legs, and genitourinary incontinence. Lumbar myelography showed complete block at the Th9 level. MRI showed stenosis of the spin-al canal at the Th8/9 level, and a deviation of the spinal cord. MRI with Gd-DTPA showed that the spinal cord was compressed by intradural extrameclullary tumors. However myelography and MRI could not detect the multiplicity of tumors. CT myelography demonstrated three separate tumors from the Th7 to the Th9. Three tumors were totally removed. Histopathologically, they were meningotheliomatous meningiomas.

These cases were considered as being multiple meningiomas of the spine. Both patients showed no ma-nifestations of von Recklinghausen's disease. The cause of the multiplicity in these cases was uncertain. Multiple spinal tumor is very difficult to diagnose be-cause of unusual clinical symptoms. Recently, MRI has become a most valuable means of examination to detect spinal tumors. This case of spinal meningiomas was re-ported in which CT myelography was more useful than MRI to detect multiplicity.