脊髄硬膜外Angiolipomaの1例

Spinal Extradural Angiolipoma: A case report

I．はじめに

　Angiolipomaは中枢神経系においてはまれな腫瘍である．ほとんどが脊髄に存在し，spinal lipomaのvariantといわれたこともあったが^2,3），多くの点で臨床像が異なり，独立したclinical entityであることが認められている^1,5,8,12）．今回われわれは，まれなangiolipomaの中でも典型的と考えられる脊髄，硬膜外，背側に存在した症例を経験した．本症に特徴的と考えられる紡錘形のMRI矢状断像とともに，症例報告する．

This 60-year-old man had been well until four yearsprior to admission, when he developed slowly progres-sive weakness of the lower extremities. On admission he was found to have a spastic paraparesis, sensory disturb-ance below the level of T10 and mild sphincter dysfunc-tion. Conventional myelography and CT myelography demonstrated an epidural mass located from T5 to T8 vertebral level. MRI revealed that the epidural mass was fusiform and markedly enhanced by the contrast medium. Laminectomy was performed and a fibrous tumor red in color was subtotally removed. Histological findings were consistent with those of angiolipoma. Angiolipoma is a rare tumor in the central nervous sys-tem and is regarded as a clinical entity different from a spinal lipoma. Occurrence of angiolipoma in the central nervous system has been reported in 40 cases in the world literature. Thirty nine cases of them occurred in the spinal canal, especially in the dorsal epidural space of the thoracic region. The fusiform shape demonstrated in this case might also be characteristic of angiolipoma in this region.