頭頂部に生じたsinus pericraniiの1治験例

A Case of Sinus Pericranii Manifesting as a Parietal Midline Mass

I．はじめに

　Sinus pericranii（以下SP）は，硬膜静脈洞と交通する頭皮血管腫瘤であり，1850年，Stromeyerの報告以来^11），約160例の報告がある^13）．臨床上稀な病態であり，本病態に関する成因，治療方針に関してはいまだ一定の見解はない．今回われわれは頭頂部に生じた交通路の小さなSPに対して開頭術を行わずに腫瘤の摘出および交通路の遮断を行い治癒し得た1例を経験し，本病態の成因，診断，および治療に関して文献的考察を行ったので報告する．

A case of sinus pericranii was reported. A 5-year-old boy was admitted to our hospital, complaining ofscalp mass located at the midparietal region. He was noticed to have had it since 3 years before. The massdecreased in size under mild compression, and during standing position, but increased in size due to lyingdown.

Magnetic resonance imaging (MRI) demonstrated a mass with mixed signal intensity on the T1 weight-ed image and high signal intensity on the T2 weighted image. Gd-DTPA study showed irregular enhance-ment. Cerebral angiogram showed no communication between the mass and the superior sagittal sinus.Neither did direct injection of contrast medium into the mass revealed any communication. 3D-CT demon-strated three tiny bone defects beneath the mass. Open surgery revealed that the mass existed between thegalea aponeurotica and the periosteum, which had a small communication with the emissary vein. Patholo-gical examination showed a multiple lobular cyst with endothelial wall lining.

This case report hightlighted the fact that sinus pericranii with minimal communication with the duralsinus can be treated by removal of the mass and closure of the cranial bone abnormalities with bone waxwithout craniotomy.