頭蓋および頭蓋内Chondroma

INTRACRANIAL AND CALVARIAL CHONDROMAS

I．はじめに

　頭蓋および頭蓋内に発生するchondromaは，きわめて稀な腫瘍である。Cushing^12）の2023例の脳腫瘍の中に3例，Olivecrona^21）の4135例の中に4例，Tonnis^18）の6000例以上の脳腫瘍に12例を数えたに過ぎない。1951年，ZülchのclinicのKlingler^17）が自験例5例を含む31例の頭蓋底に発生したchondromaを文献的に総括した。また1961年，Aronson^2）は，自験例を世界で第51番目の頭蓋内軟骨腫として報告した。著者らが文献的に確認したところでは，現在まで，95例（頭蓋底部58例^{2）2）12）13）15）17）18）21）27）29）30）31）}，後頭骨7例^{9）14）16）19）24）}および髄膜性31例^{1）3）6）7）8）10）11）20）25）26）32）}に達している。本邦での報告は，未だ見られないようである。

　当科においては，約2,900例の脳腫瘍の中に中頭蓋窩2例，上矢状静脈洞旁部1例，および後頭骨の1例の計4例のchondromaを経験している。ここで，この稀な腫瘍について，当科の症例を報告し，文献的考察を加えたいと思う。

1) Intracranial and calvarial chondromas are very rare tumors. 4 cases of chondromas among total 2900 cases of brain tumors in our clinic two cases in the parasellar region, one case arising from the occipital hone and one case adherent to the dura of parietal region) were described. Furthermore, total 96 cases of cranial caltilaginous tumors were collected from the world literatures. Based upon the statistical data of all these cases including our four cases, the clinical and pathological characteristics of these tumors were discussed.

2) The caltilaginous tumors arising from men-inges or choroid plexus were also classified as chon-dromas when they showed chondromatous appearan-ce by histological examinations.

3.) These tumors occur in the third through the fifth decade of life and show some predilection for females. The patients present clinical manifestations of slowly growing space-occupying lesion. Calcified shadow and destructions of bone are the roentogeno-graphic findings of these tumors. Surgical treat-ments, when they are removed as much as possible, are always of great benefit. However, chondrosar-comas, found in 20% cases of these caltilaginous tumors grow sometimes infiltratively into the brain tissue and show rapid recurrence when total removal is macrospically performed.