Radiosurgery直後に腫瘍出血を生じた転移性脳腫瘍の1例

Peritumoral Hemorrhage Immediately after Radiosurgery for Metastatic Brain Tumor

Ⅰ．はじめに

　転移性脳腫瘍に対するStereotactic Radiosur-gery（SRS）はその高い局所制御率，生存率の延長，QOLの向上が得られることより，多くの症例で治療の第一選択となっている．

　また照射に伴う放射線壊死や脳浮腫といった重篤な合併症は晩期に生じるものがほとんどで，中間生存期間が1年未満の転移性脳腫瘍患者に対しては特に深刻なものとは考えられておらず，SRSは安全に施行できる治療と考えられている．しかし，今回われわれは照射直後に生じた症候性の腫瘍出血（peri-tumoral hemorrhage）を経験したので，文献的考察を加え報告する．

We report a case of a 44-year-old woman with metastatic brain tumors who suffered peri-tumoral hemorrhage. soon after stereotactic radiosurgery (SRS). She had been suffering from breast cancer with multiple systemic metas-tasis. She started to have headache, nausea, dizziness and speech disturbance 1 month before admission. "I'here was no bleeding tendency in the hematological examination and the patient was normotensive. Neurological examination disclosed headache and slightly aphasia.

Magnetic resonance imaging showed a large round mass lesion in the left temporal lobe.