悪性Gliomaと他臓器悪性腫瘍重複例の検討

A Survey of Malignant Gliomas Accompanied with Visceral Malignancies

I．はじめに

　近年，悪性腫瘍の医療成績の向上に伴い，重複癌の報告も散見されるようになった．しかし，悪性gliomaと他臓器悪性腫瘍との重複例は稀とされており，その臨床的特徴などの検討は充分にされていない．今回われわれは当院で加療した悪性gliomaと他臓器悪性腫瘍との重複例に対し，画像所見，臨床経過につき検討を行い，その治療を行う上で有意義と思われる知見を得たので報告する．

From January 1984 to December 1997, a total of six patients with malignant gliomas accompanied withvisceral malignancies were treated in our department. We reviewed their radiological findings and clinicalcourse.

They consisted of four patients with glioblastoma and two patients with anaplastic astrocytoma. Classi-fied according to visceral malignancies, three cases had colon cancer and the rest consisted of thyroid, uter-us and prostate cancers. In radiological examinations of the brain (CT scans and MR images), thesegliomas were relatively well-circumscribed, as if they were metastatic brain tumors. Of all these six cases,two cases survived more than five years and there were two cases in which there was recurrence withinayear. Particularly, in four cases, whose gliomas developed after the treatment for visceralmalignancies,two cases survived long-term (more than five years) and there was recurrence in only one case. We specu-lated that visceral malignancies could affect the nature of glioma progression. Thinking about itsmecha-nisms, we hypothesized as follows ; (1) visceral malignancies may activate non-specific, or commonanti-tumor, immunity. (2) visceral malignancies may produce some factors which could affect thebiological na-ture of gliomas. (3) glioma accompanied with visceral malignancy may have genetic uniqueness.Althoughthe cases were limited in number, the present study may be helpful in designing the treatment for suchcases and in elucidating the invasive nature of gliomas.