頭蓋内外に進展した気管原発転移性脳腫瘍の1例

A Case of Intra- and Extracranially Extensive Metastatic Brain Tumor of Tracheal Cancer Origin

I．はじめに

　原発性気管癌は発生頻度が低く，遠隔転移ことに脳転移に関する報告は極めてまれである．一方，全身諸臓器の悪性腫瘍が脳転移を起こす場合，脳実質内，殊に皮髄境界部に転移発育することが多く，硬膜あるいは頭蓋骨への転移は比較的まれである^17）．今回われわれは，硬膜または頭蓋骨に転移し，頭蓋内外に大きく進展した気管癌による転移性脳腫瘍の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．

The authors report a case of metastatic brain tumor of tracheal cancer origin, itself a rare condition. A 55-year-old man was admitted with complaints of headache, ato-nic seizure of left lower limb and right temporal swelling. On admission, the patient had left recurrent nerve palsy. CT scan displayed right temporal bone destruction and ring-enhanced mass. MRI disclosed that the mass con-tained an inner necrotic region and a perifocal edema.Right common carotid angiogram revealed that the tumor was fed only by narrowed vessels of the middle meningeal artery. Subtotal removal of the tumor was performed, and histological examination revealed cranial metastasis of tracheal squamous cell carcinoma. Post-operative course was uneventful, and the patient under-went medical treatment for the primary lesion before post-operative brain-irradiation.