軟脳膜原発性悪性黒色腫の1例について

A CASE OF PRIMARY DIFFUSE MELANOMA OF THE CENTRAL NERVOUS SYSTEM

I．はじめに

　中枢神経系原発の黒色腫はかなりまれなものではあるが，文献上それと考えられるものを拾つてゆくとVirchow^63）にはじまつてすでに海外文献上144例^42）53）を超える報告に接し，また白色人種に比し黒色腫の少ないといわれる^67）わが国においても10例^{1）−7）11）12）}の報告に接することができる。これら原発性黒色腫の臨床像ならびに剖検所見はさまざまであり，発生学的，解剖学的見地から，あるいは脳神経外科学的見地から種々の分類が試みられている^{19）42）44）47）51）61）66）}。Piscol　＆　Hof—fmann^53）は自験例2例を含む122例を詳細に検討した結果，臨床的分類として，

　i） Pigment hyperplasia　＆　hamartoma

A case, 23-year-old female, with a primary diffuse melanoma of the central nervous sys-tem is presented. Because of signs of severe increased intracranial pressure, exploratory craniotomy was performed and the diagnosis of a diffuse melanoma of the leptomeninx was first established. After the surgical de-compression regional chemotherapy of the melanoma by bilateral cerebrall perfusion was performed. Even 1.0 grm of Endoxan was used for the perfusion, the tumor showed little sensitivity. Death occurred 3 months after the operation, being 10 months after the onset of symptoms.

Postmortem examination revealed diffuse melanoma of the leptomeninx of the whole central nervous system. Melanoma was not found in any other organ.

Primary melanoma of the central nervous system is rather uncommon. About 150 cases have been heretofore reported and in Japan only 11 cases in cluding the present case have been reported. The latter was summarized and literatures on the disease were reviewed.