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Neurological Surgery No Shinkei Geka Volume 23, Issue 10 （October 1995）

Neurological Surgery 脳神経外科 23巻10号（1995年10月発行）

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6年間の経過で再発をきたしたpleomorphic xanthoastrocytomaの1例—のう胞壁の切除は必要か？ Recurrence of Pleomorphic Xanthoastrocytoma Six Years after Total Removal of Mural Nodule:a case report 坂本辰夫 ^1,4 , 榊原陽太郎 ¹ , 林龍男 ¹ , 山下弘一 ¹ , 関野宏明 ² , 小澤智子 ³ , 田所衛 ³ Tatsuo SAKAMOTO ^1,4 , Yotaro SAKAKIBARA ¹ , Tatsuo HAYASHI ¹ , Koichi YAMASHITA ¹ , Hiroaki SEKINO ² , Tomoko OZAWA ³ , Mamoru TADOKORO ³ ¹聖マリアンナ医科大学東横病院脳神経外科 ²聖マリアンナ医科大学脳神経外科 ³聖マリアンナ医科大学第1病理 ⁴町田市民病院脳神経外科 ¹Department of Neurosurgery, St. Marianna University Toyoko Hospital ²Department of Neurosurgery, St. Marianna University School of Medicine ³First Department of Pathology, St. Marianna University School of Medicine キーワード： Plemorphic xanthoastrocytoma , Cystic tumor , Recurrence , Long-term follow-up , Cyst wall Keyword: Plemorphic xanthoastrocytoma , Cystic tumor , Recurrence , Long-term follow-up , Cyst wall pp.941-945

発行日 1995年10月10日 Published Date 1995/10/10

DOI https://doi.org/10.11477/mf.1436901102

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Abstract 文献概要
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I．はじめに

　腫瘍摘出後6年の経過で再発したpleomorphic xan—thoastrocytoma（PXA）の1例を経験し，病理組織学的検索からPXAの手術法に関して若干の知見を得たので報告する．

A case of recurrent pleomorphic xanthoastrocytoma (PXA) was reported. A 46-year-old male underwent total removal of mural nodule from cystic tumor in the left temporal lobe in 1986. Histological diagnosis was astrocytoma. There were no abnormal neurological signs or symptoms after the operation. However, 6 years after the operation he complained of strong un-pleasant smell as of rotten onions and was admitted to our hospital. MRI revealed a cystic tumor with a mural nodule which was enhanced markedly by Gd-DTPA in the same location as previous tumor site. He was oper-ated upon again and tumor was removed with the cyst wall. Histological diagnosis was PXA.

Surgical procedures for removal of cystic PXA has been controversial; removal of tumor only, tumor re-moval with biopsy of cyst wall, or tumor removal with resection of cyst wall.

Real reason for recurrence of this tumor in our case is unknown. However, since astrocytoma cells were found in the biopsy specimen of the cyst wall at time of the first operation, the tumor might have recurred from these cells. Therefore, this time we removed not only the mural nodule but also the cyst wall, because the cyst wall peeled off easily. We would like to propose that PXA cyst walls should be resected, whenever possible, in order to accomplish total removal of tumor.