多発性髄膜腫Multiple Meningiomas

MULTIPLE MENINGIOMAS

はじめに

　髄膜腫は全頭蓋内腫瘍の12〜18％を占めるが，多発性のことは少ない。Cushing　＆　Eisenhardt^5）はvon Re—cklinghausen氏病（以下レ氏と略）に伴なつてみられる多発性に発生する髄膜腫や髄膜腫症（meningiomato—sis）との間の区別は必ずしも明確ではないとしながらもレ氏病を伴なわないmore than one meningioma andsomething less than a diffusion of tumorsを多発性髄膜腫（multiple Ineningiomas）と呼んでいる。Cushi—ng　＆　Eisenhardtは295例の髄膜腫中4例が多発性髄膜腫であつたと述べている。この定義に従うと1941年から1970年までにわれわれが経験した手術あるいは剖検によつて確認された髄膜腫233例中多発性髄膜腫はわずか3例である。大阪赤十字病院では1963年から1970年までの28例の髄膜腫中わずか1例である。以下この4症例について報告し，文献的考察を加える。

In spite of their frequent occurrence among brain tumors, the meningiomas are rarely seen as a multiple growth. The incidence of multiple men-ingiomas, defined by Cushing and Eisenhardt as more than one meningioma and something less than a diffusion of tumors in the patient without the stigmata of von Recklinghausen's neurofibro-matosis, is 1 to 2 per cent. Four patients with multiple meningiomas have been encountered among 261 patients with verified meningioma.

Case 1. A 14 year old girl was found to haveright parasagittal and right sphenoid wing mening-iomas with small nodules over the dura in the righttemporal region at operation and autopsy.

Case 2. A 50 year old female had two mening-iomas along the right side of the falx and one onthe left, two in the left anterior fossa and one inthe right, two in the left lateral ventricle and onein the right, one in the left petrous portion andtwo in the right, each one under the tentorium,and many small nodules in the dura of the cere-bral convexity bilaterally.

Case 3. A 34 year old female who sufferedfrom convulsive seizures, underwent two cranioto-mies and seven separate meningiomas in the leftcerebral convexity were successfully removed.

Case 4. A 42 year old female underwent twocraniotomies and two meningiomas, one arisingfrom the left side of the tentorium and the otherembedding in the left cerebellar hemisphere, were successfully removed.