複雑な臨床経過を示した脳奇型腫症例

A BRAIN-TERATOMA WITH COMPLICATED SYMPTOMS

序言

　脳奇型腫に関する報告は従来決して稀なものではない。日本における統計では桂教授らは全脳腫瘍3097例中31例，西本氏らの統計で175例中2例という。小児脳腫瘍ではこの奇型腫が最も生存期間が短くて約半年と言われる（福山）。又1953年このかた日本では中田教授の手術成功以来2,3の外科的経験が報ぜられている。それでもなお敢えてここに報告したいのは本例が後述の如くやや複雑な症状を呈し，臨床的立場から神経病学的に意義があると考えるからである。

The patient is a 12-year old boy. His initial symptom was noticed by the convulsive sei-zure, and then his complaints developed in order of the following description: the symp-tom of the increase of intracranial pressure (headache, vomitting etc), the Parinaud's sign of eye ball movement, the disturbances of the consciousness, the syndrome of the pubertas praecox, and the particular rigorous posture.

The autopsy revealed that these symptoms were caused by a giant teratoma in the brain. According to the clinical symptoms and to the findings of autopsy, we suggest that the primary tumor in the third ventricle grow and spread to the pineal region, the hypoth-alamus and the superior region of the mid-brain.

Of all symptoms above mentioned, especia-lly the syndrome of pubertas praecox and the particular rigorous posture are much interested.

1. On the pubertas praecox.

It has been reported that there were three theories about the origin of this syndrome (being due to the lesion of the pituitary gland, of the pineal body or of the region of tuber cinereum).

But our present case teachs that the lesion of tuber cinereum is the most important source of this syndrome.