慢性被膜化脳内血腫の1例

A case report of chronic encapsulated intracerebral hematoma

I．はじめに

　脳腫瘍類似の画像所見を呈した慢性被膜化脳内血腫の1例を報告し，本血腫の臨床像，病因や病態に関して若干の考察を加えた．

Chronic encapsulated intracerebral hematoma is a rare clinicopathological entity. The authors reported a case of a 52-year-old male who presented with progres-sive sensory disturbance of the left extremities three weeks prior to admission. Plain CT and MRI scans re-vealed a subcortical mass in the right temporal lobe associated with extensive peritumoral edema and intra-tumoral hemorrhage (mixed intensity on T1WI, low in-tensity on T2WI). There was a ring-like enhancement with GdDTPA. These findings strongly suggested metastatic melanoma associated with intratumoral hemorrhage. During the operation, the mass appeared partly at the surface of the brain and was easily extir-pated totally. Histologically, the specimen showed chro-nic encapsulated hematoma with a thick, fibrous cap-sule and there was no evidence of neoplasm. The post-operative course was uneventful and follow up CT scan showed disappearance of the mass and the surrounding edema. The relevant literaure was reviewed, and the pathogenesis of this entity was discussed.