全摘した20年後に多発性に再発した小脳血管芽腫の1例

Multiple Recurrences of Cerebellar Hemangioblastoma after 20 Years from Initial Total Removal of the Tumor

　Ⅰ．はじめに

血管芽腫は，成人の小脳に発生する血管に富んだ良性腫瘍である．単独病変として発生する場合とvon Hippel-Lindau（VHL）病の一部として出現する場合がある．多発性も約10～15％に認められる．長期に観察すると一部では多発性に再発すると報告されている³⁾．今回われわれは，血管芽腫摘出20年後に小脳に多発性に再発を認めた1例を経験したので報告する．

　Cerebellar hemangioblastoma develops alone or develops as part of von Hippel-Lindau disease. Moreover,multiple hemangioblastomas are found in 10-15％. It was reported that some hemangioblastomas recur with multiple recurrence in long time follow-up period. A 51 years old male was referred to our hospital because of headache and found a cerebellar tumor which was totally removed and diagnosed as hemangioblastoma pathologically. He presented no deficit after first surgery,but he did not come our hospital. In May 2000,he was referred to our hospital because of headache again and found five cerebellar tumors on MRI. Angiography showed markedly tumor stain. Retinal and spinal lesions were not seen. Two of five tumors was removed. The remaining three small tumors were received gamma knife surgery. In December 2000,because of cyst enlargement,one tumor was removed and the cyst was opened. In June 2001,he presented right hearing disturbance due to enlargement of cerebellar pontine angle tumor. The tumor was removed after tumor embolization,but hearing disturbance and slight dizziness remained. The remaining 5mm tumor is followed.