Meckel's caveに発生したepidermoidの1例

A case of epidermoid tumor inside the Meckel's cave

I．はじめに

　頭蓋内類上皮腫は原発性脳腫瘍では稀で0.2-1.0％にみられ^20,22），40歳台に最も多い^3），本腫瘍は小脳橋角部に50％と多く，他に錐体骨先端部，板間層，鞍上部及び傍トルコ鞍部にもみられるが^5,19），Meckel's caveに発生したものは極めて稀である^18）．われわれはMec—kel's caveに発生した類上皮腫の1例を経験したので，若干の文献的考察を加えて報告する．

An epidermoid tumor inside the Meckel's cave is rare. The symptoms caused by this tumor include trigeminal neuralgia, facial hypesthesia and paresis of the 3rd, 4th and 6th nerves. A case of epidermoid tumor inside Meckel's cave was presented. A 54-year-old female who had complained of 3rd nerve palsy with right facial hypesthesia since 3 years before was refer-red to our clinic. Magnetic resonance imaging (MRI) showed the tumor at Meckel's cave. The tumor remov-al was performed using the orbito-zygomatic approach.To avoid injury of the internal carotid artery and nerves inside the cavernous sinus, removal of the tumor inside the capsule was carried out leaving the capsule.Postoperatively, the tumor removal was confirmed by MRI and improvement of the 3rd and the 5th nerve palsy was obtained three months after surgery. This case suggests that the capsule of the tumor inside the Meckel's cave should be allowed to remain to avoid in-jury of the adjacent 4th, 5th and 6th nerves and of the internal carotid artery.