自然破裂を来した鞍上部嚢胞性病変の1例

A Case of Spontaneous Rupture of a Suprasellar Cystic Mass

I．はじめに

　自然破裂を起こす嚢胞性脳腫瘍例のほとんどは，上皮腫，類上皮腫，くも膜嚢胞などの先天性腫瘍であり^3,12），発症部位に関しては傍下垂体部，小脳橋角部および穹窿部などが一般的である．今回われわれは保存的加療中，自然破裂を来した鞍上部嚢胞性病変の1例を経験したため，鞍上部腫瘍の自然破裂例の文献的考察を含め報告する．

The author reported a case of a spontaneous rupture of a suprasellar cystic tumor. A 67-year-old man complained of bitemporal homonymous hemianopsia. His visual acuity was 0.02 on the right side and 0.04 on the left side. Skull XP revealed no abnormal findings, but brain CT scan showed a cystic mass without calcification in the suprasellar region. Brain MRI at the same lesion site depicted a low-intensity mass on Tl-weighted image without gadolinium enhancement, and a high-intensity mass on T2-weighted image.The patient was treated conservatively because of complications such as diabetes mellitus, cerebral infarc-tion and old myocardiac infarction. MRI taken 5 years after the initial MRI revealed disappearance of the suprasellar cystic mass. However, the patient's neurological findings, including visual signs, revealed no deterioration. His physical and radiological findings had remained uneventful. In this report, we reviewed the literatures about spontaneous rupture of suprasellar cystic tumors. It was considered that in this case, according to the neurological, radiological and CSF findings, the suprasellar cystic mass might be a Rath-ke's cleft cyst or arachnoid cyst.