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Neurological Surgery No Shinkei Geka Volume 21, Issue 11 （November 1993）

Neurological Surgery 脳神経外科 21巻11号（1993年11月発行）

Japanese English

症例

Tectal Gliomaの1例 A Case of Tectal Glioma 社本博 ¹ , 白根礼造 ¹ , 小川彰 ² , 吉本高志 ¹ Hiroshi SHAMOTO ¹ , Reizo SHIRANE ¹ , Akira OGAWA ² , Takashi YOSHIMOTO ¹ ¹東北大学脳神経外科 ²岩手医科大学脳神経外科 ¹Division of Neurosurgery, Institute of Brain Diseases, Tohoku University School of Medicine ²Department of Neurosurgery, Iwate Medical University School of Medicine キーワード： Tectal glioma , Hydrocephalus , Midbrain , Surgery Keyword: Tectal glioma , Hydrocephalus , Midbrain , Surgery pp.1055-1059

発行日 1993年11月10日 Published Date 1993/11/10

DOI https://doi.org/10.11477/mf.1436900745

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Abstract 文献概要
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I．はじめに

　今回われわれは稀な中脳被蓋のgliomaの1例を経験し，MRI所見を中心に文献的考察を行ったので，報告する．

A case of tectal glioma with mild choked disc is re-ported.

An 11-year-old boy was admitted to our hospital be-cause of visual disturbance and choked disc. Neurologi-cally, the patient had nothing but choked disc.

Magnetic resonance imaging (1.5T) was performed.Relative T₁ weighted image showed a lesion of low sig. nal intensity, and T₂, weighted image showed high in. tensity, about 1.0 X 1.0cm in size, at the pineal region. The sagittal view showed a mass at the tectum, and ste-nosis of the aqueduct.

It was diagnosed as tectal glioma. Left occipital cra-niotomy was performed and the tumor was removed sub-totally.

Histological examination demonstrated a fibrillary astrocytoma.

Radiochemotherapy was performed postoperatively. Tectal glioma is very rare. The differential diagnosis from germ cell tumor or pineal cyst is essential for treat-ment. The authors performed an operation in order to re-move the tumor and determine the course of treatment. The angiogram showed marked tumor stain feeding from the bilateral middle meningeal artery and the superficial temporal artery. On operation, the tumor was shown to be elastic soft, and existed in the epidural and subcutaneous space. It was invading the diploic, with infiltration into the dura. The tumor was detached from the dura matter and totally resected. The histological diagnosis was malignant lymphoma (B cell type).

After the operation, the patient's left hemiparesis im-proved without additional neurological deficit. Bone and tumor scintigraphy disclosed no uptake other than that of the head. The tumor was diagnosed at primary malig-nant lymphoma of the skull. After 50-Gy radiation and chemotherapy, the postoperative course was uneventful. Although the number of reports on malignant lympho-ma has increased recently, there are only 15 case re-ports concering those in the skull. The neuroradiological findings and differential diagnosis of malignant lympho-ma in the skull were mainly discussed.