小脳テントより発生したmesenchymal chondrosarcomaの1例

Intracranial Mesenchymal Chondrosarcoma Arising from the Cerebellar Tentorium : case report

I．はじめに

　頭蓋内発生するchondrosarcomaは，全脳腫瘍の0.1-0.2％とまれな疾患である^2,4,15）．とくに，mesenchymal chondrosarcomaは，最も未分化で局所再発をくりかえし，予後不良である^3,5,7）．この治療法に関しては，できるだけ外科的に摘出するしかなく，放射線療法や化学療法は効果がないとされている^10,13）．

　今回，われわれは，小脳テントに発生したmesenchymal chondrosarcomaを経験したので治療法を中心に文献的考察を加え報告する．

A 22-year-old woman presented with a 3-year history of progressive frontal headache. Computerizedtomography (CT) and magnetic resonance imaging (MRI) revealed a tumor in the left trigone of the lateralventricle and which enhanced homogenously. The tumor was attached to the cerebellar tentorium and wascompressing the brain stem. On the angiography, no tumor staining was seen. On November 26, 1996, totalremoval of the tumor was performed using the left subtemporal approach. The tumor was attached to thecerebellar tentorium. The pathological diagnosis was mesenchymal chondrosarcoma. After surgery,gamma-knife radiosurgery was carried out on the tentorium at the place where the tumor had beenattached. There has been no recurrence fur 6 months. Mesenchymal chondrosarcoma in the brain is veryrare and therapy for this tumor is difficult. We report this rare tumor and the therapy is discussed.