頭蓋底に発生せる脊索腫の2例

Two Cases of Chordoma on Clivus Blumenbachi

　脊索腫は胎生期の脊索の遺残物より発生する腫瘍で，その発生部位としてはBlumenbach氏斜台及び仙骨部に多いことが知られている。脊索腫は1856年Virchowが剖検により斜台に発生した鬼胎様の粘液性腫瘍を楔状後頭骨部水泡形成性軟骨腫Enchondrosis physalifosa sphenooccipit-alisとして報告したのが最初の例で，以来現在まで100年間に報告せられた脊索腫は欧米において約300例であり，本邦においては僅かに12例に過ぎない。そしてその大多数は割検により発見せられたものであるが，私達は手術により剔出した切片により本症であることを認めた1例と，手術後死亡し，剖検により始めて本症であることを認めた1例とを経験したのでここに報告する次第である。

It has been clarified that the chordoma originates from the remnants of the embryo-nic chorda dorsalis. Chordoma that produce clinical symptoms are rare and up to the present time about 300 cases have beem repor-ted in the overseas and only 12 cases in Japan.

Recently, we experienced two cases of chor-doma on the clivus Blumenbachi.

Case 1. A 16 years old male: 2 years and 8 months before admission, the patient had noticed diplopia. Thereafter, he complained of tinnitus in the left ear, diminution of hearing, headache, dysphagia and paresthesia on the left side of the face and the tangue. Examination: Visual power and field of both eyes were normal. The pupils were normal in size and reacted to light. Both optic disks were congested. There were noticed paralysis of the external rectus muscle of the left eye ball, nystagmus, paresthesia and hypesthesia on the left side of the face and the tangue, no corneal reflex on the left side, unsteadi-ness and deviation to the left in walk. The uvula deviated to the right. Romberg pheno-mena was positive All tendon reflexes of the left side were hyperactive, however, there was no pathological reflex.