頭蓋腔内腫瘍の脊髄腔内転移の2症例

INTRATHECAL METASTASES OF THE INTRACRANIAL TUMORS:TWO CASE REPORTS

　脳腫瘍，特に悪性Gliomaが同一頭蓋腔内に，播種性転移を来す事はそれ程稀な現象ではなく，本邦に於ても既に幾多の剖検例の報告がある。然るに脊髄転移は，身体各部への転移の極めて稀有なのに比較すれば梢々多く見られるが，medullo-blastomaを除いてはかなり稀なものである。Ollivier （1837）^1）が第4脳室に原発腫瘍を有した1例を報告して以来，脊髄腔内転移を生じた症例の報告も，欧米ではかなりの数にのぼっているが本邦にては尚2,3の報告例に過ぎない。

　最近吾々の教室に於てPinealolna及び小脳虫部悪性meningiomaの亜全剔出後，いずれも諸症状著明に改善し，其の後も定期的検診を行つていたのであるが，術後約1力年半経過して脊髄に，或いはその転移ではないかと思われる腫瘍発生をみ，手術の結果確実にそれぞれの転移腫瘍である事をたしかめ得た2症例があるので茲に報告し，いささか考察を加えることにする。

Spinal metastases of the primary brain tumors are relatively rare, and are little verified prior to autopsy, especially in our country. Recently, we have experienced two cases of intrathecal metastases of the primary intracranial tumors, which were determined by laminectomy and histological examination. One case is a 24 years-old male with pineal-oma and the other is a 12 years-old girl with sarcomatous meningioma in the cysterna magna, respectively. Both cases had asymp-tomatic period after the first operation, which were subtotally extirpated and treated by Co⁶⁰ or X-ray radiation postoperatively. One and half year after the first operation, the symptoms of tumor appeared, which were im-planted on the leptomeninges and spinal cords of the thoracic segments. Histological exami-nation revealed pinealoma, and sarcomatous meningioma, respectively.

From above mentioned, we discussed the intrathecal metastases of the intracranial tumors via cerebrospinal fluids, especially of gliomas.