シルビウス裂内ruptured dermoid cystの1例

A Case of a Ruptured Dermoid Cyst in the Sylvian Fissure

Ⅰ．はじめに

　頭蓋内dermoidは稀な腫瘍で全頭蓋内腫瘍の約0.2〜0.3％を占める^1）．胎性期外胚葉の迷入によるものと考えられ，通常嚢胞変性を来しているためdermoid cystとも呼ばれる．時に髄液腔内にcystがruptureし画像上多発性病変を呈することが知られている．今回，われわれは画像上くも膜下腔内に多発性病変を認め，主病変摘出により良好な経過をたどった頭蓋内ruptured dermoid cystの1例を経験したので，文献的考察を加え報告する．

A 22-year-old woman was admitted to our department after developing a headache. The neurological findings were unremarkable on her first visit, but CT demonstrated a lot of low-density masses in the subarachnoid space. The larg-est mass was in the right sylvian fissure. These lesions appeared hyper-intense in T1, T2 and diffusion-weighted MR images. A right frontotemporal craniotomy was performed to remove the main mass lesion in the right sylvian fis-sure. During surgery, thickening of the arachnoid membrane and floating oily globules were seen in the subarachnoid space.