頭蓋内多発転移および脊髄播種を来たしたACTH産生下垂体腺腫の1例

ACTH Producing Pituitary Adenoma with Multiple Intracranial Metastases and Spinal Dissemination

I．はじめに

　頭蓋内多発転移および脊髄播種を来たしたACTH産生下垂体腺腫の1例を経験した．主に治療および病理学的問題点について文献的考察を加え報告する．

A 34-year-old male developed multiple intracranial and intraspinal metastases from an invasive ACTH secreting pituitary adenoma.

He was initially admitted to our hospital complaining of visual loss 10 years ago, presenting a pituitary tumor with suprasellar extension. At first, transsphenoidal surgery was performed, and histological finding was pituitary apoplexy. He developed recurrence of the tumor 2 times. At the second, third and fourth opera-tion, the histological finding was an ACTH secreting pituitary adenoma with atypia.

Metastases within the central-nervous system of pituitary adenoma is a rare entity and only 21 cases have been published. A review of previously published cases follows.