出血にて発症した小脳glioblastoma multiformeの1例

A Case of Cerebellar Glioblastoma with Massive Cerebellar Hemorrhage

I．はじめに

　Glioblastoma multiforme（以下GMと略す）は成人に好発し，その大部分は大脳半球に原発する悪性脳腫瘍である^23）．これに対し小脳原発は稀で，現在までにわれわれの症例を含め106例の報告を認めるのみである^{1-6,8-11,13,15,16,19-22,24）}，またその際，頭蓋内圧亢進症状にて発症することが一般的とされている¹⁵．今回われわれは出血にて発症し，脳出血として手術され，組織検査にて小脳GMと診断された極めて稀な1例を経験したので報告する．

A case is reported of glioblastoma multiforme (GM) of the cerebellum associated with an intracerebellarhemorrhage. A 54-year-old male was admitted to our hospital with sudden onset of headache and nausea.CT scan showed right intracerebellar hemorrhage. The patient received conservative therapy and was dis-charged without any neurological deficits. However a second cerebellar hemorrhage attacked him ten daysafter discharge. His level of consciousness deteriorating, he underwent suboccipital craniectomy and thehematoma with the surrounding elastic tissues was excised. There were no findings suggesting hemor-rhage within the tumor on the preoperative neuroimagings, but histological examination confirmed GMwith massive hemorrhage.

To our knowledge, only 2 cases of cerebellar GM with massive hemorrhage have been reported in theliterature. Our case indicates cerebellar GM should be taken into account as a possible cause of cerebellarhemorrhage.