神経管外転移をきたした頭蓋内悪性髄膜腫の1例

A Case of Intracranial Malignant Meningioma with Extraneural Metastases

I．はじめに

　われわれは悪性髄膜腫で骨への多発性転移をきたした稀な症例を経験したので報告するとともに文献的考察を加えた．

A case of intracranial malignant meningioma with re-mote metastases to the bones is reported. A 66-year-old man with regrowth of right sphenoid ridge menin-gioma, whose meningioma had partially been removed 15 years before, was admitted to our clinic. The tumor was large enough to protrude into the lateral and third ventricles, and involved the right internal carotid, mid-dle cerebral, anterior cerebral artery and optic nerve. The tumor had irregular contour, and was hetero-geneously enhanced by Gd-DTPA on MRI. An opera-tion was performed, but a part of the tumor around these main arteries could not be removed. Histopatholo-gical examination revealed anaplastic meningioma, re-sulting from malignant change. Radiotherapy was per-formed postoperatively and the patient was discharged. Seven months after the operation he complained of posterior nuchal, back, and lumbar pain. Radiological examination revealed multiple punched-out lesions in the ribs and vertebrae, which were histologically de-monstrated to be metastases of intracranial anaplastic meningioma. Radiotherapy was carried out for the cer-vical vertebrae, but his symptoms persisted. He died of pneumonia 10 months after the operation.