巨大嚢状転移性脳腫瘍の長期生存例

Long Survival after Removal of a Huge Brain Tumor which had Metastasized from a Lung Cancer:Case report

I．はじめに

　これまで根治的治療が困難と考えられがちな転移性脳腫瘍に対しても外科摘出術，化学療法，放射線治療など集学的治療により一部ではあるが長期生存の可能性も報告されるようになってきた^4,8,10）．さらにこうした転移性脳腫瘍患者の予後に関係する要因についてもさまざまな角度より多くの検討がなされている^2,4,8,9）．当然脳に転移している腫瘍のサイズもその予後を左右する重要な要因となりうると考えられる．今回われわれは肺癌より長径6.5cmにもおよぶ巨大な転移性脳腫瘍を摘出し，術後33カ月以上再発を認めない症例を経験した．そこでこの症例について報告し，腫瘍のサイズ，その外科的摘出法とその予後に関して検討した．

Patients with large metastatic brain tumors are consi-dered to have poor prognosis. We report a case of a pa-tient with more than 33 months survival after complete resection of a huge temporal tumor which had metasta-sized from a lung cancer. A 57-year-old woman pre-sented left hemiparesis and disturbance of conscious-ness. Magnetic resonance images revealed a huge cystic mass lesion in the right temporal lobe. After a macros-copically complete excision of the tumor, she received radiation therapy (whole brain 50 Gray). She had re-ceived lung surgery for the primary lung cancer, 2 years prior to brain metastasis. Histological examina-tion showed papillary tubular adenocarcinoma which was similar to the previously resected lung cancer. Thirty three months after the resection of the intracra-nial tumor, she has no neurological deficits and no signs of recurrence of either brain tumor or lung tumor. We discuss the size of metastatic brain tumor and the postoperative prognosis of patients with metastatic brain tumor.