頚椎硬膜内ganglion cystの1例

Intradural Extramedullary Ganglion Cyst of the Cervical Spine. Case Report

　今回われわれは，極めて稀な頚椎硬膜内髄外に発生したganglion cystの1例を経験したので，文献的考察を加えて報告する．症例は54歳の男性で，手術で嚢胞性病変を摘出し，内容液がゼラチン様の粘調な液体であったこと，病理組織診断で嚢胞壁に細胞成分がなく線維性結合組織からのみ形成されていることより，ganglion cystであると診断した．非常に稀ではあるが，ganglion cystも硬膜内髄外の嚢胞性病変として念頭に置く必要がある．

　Ganglion cysts usually occur at the wrist or finger joints, and they rarely occur in the spinal region.　We report a case of intradural extramedullary ganglion cyst in the cervical region that was diagnosed on the basis of the clinical and pathological findings.　A 54-year-oldman was admitted to our hospital with a chief complaint of inability to elavate his left shoulder.　MRI revealed an intradural extramedullary cystic lesion on the ventral side of the spine at the C2 level.　The cyst was some distance away from the facet joints.　A CT myelogram showed a concave deformity of the spinal cord due to compression by the cyst.　C2 and C3 hemilaminectomy and total removal of the cyst, which contained clear and gelatinous fluid, was performed.　The cyst was in contact with the anterior surface of the dura mater and had no connection with the facet joint.　Histological examination showed that the cyst wall consisted mostly of fibrous connective tissue and had no synovial cell lining.　The cyst was therefore diagnosed as a ganglion cyst.　We also review previous reports and discuss the clinical and pathological features of spinal ganglion cysts.