著明な骨破壊と脊柱管内上方進展を認めた巨大仙骨部神経鞘腫の1例

Giant, Invasive Sacral Schwannoma Extending to the 4th Lumbar Spine

Ⅰ．はじめに

　脊髄腫瘍の中で神経鞘腫は最も頻度の高い疾患であるが，仙骨および腸骨の著明な骨破壊を来したという報告は少なく，さらに脊柱管内を上方に進展したものは極めて稀である．文献上，広範な骨破壊を認めた仙骨部巨大神経鞘腫は自験例を含め過去30例報告されており，そのうち，腰椎の脊柱管内への上方進展したものは5例のみであった^{12,16,17,25）}．

　今回われわれは，L4レベルまで上方進展した仙骨部巨大神経鞘腫の1例を経験したので報告する．

In this report, we describe a case with giant sacral schwannoma, which invasively extended to the 4th lumbar spine and to the surrounding sacral and iliac bone. A 26-year-old female was admitted to our hospital because of numbness and transient weakness of the right leg, and dysuria. Radiological examinations revealed that a giant sacral tumor, associated with multiple cystic formations, had invasively extended to the 4th lumbar spine, sacrum, and iliac bone. She underwent partial removal of the tumor, followed by irradiation. Pathological diagnosis was schwannoma.