間歇的疼痛をきたした脊髄硬膜外血管脂肪腫の1例

Spinal Extradural Angiolipoma: A case report

I．はじめに

　血管脂肪腫は皮下あるいは筋組織内にしばしば発生するが，中枢神経系における発生は稀である^5）．今回，両足底部冷感および腰部から両下肢にかけての間歇的疼痛をきたした脊髄硬膜外血管脂肪腫を経験したので神経学的特徴および病態につき検討を加えた．

Growth of angiolipoma of the central nervous system is a rare occurrence. Only about 40 cases can be collected in the literature. A 67-year-old man was admitted because of intermittent severe pain in both legs after walking. He had chillness in both legs during the past 5 years which gradually worsened.

MR image showed a spinal mass lesion at the level of Th12 to L1. The lesion was isointense on Tl-weighted image and slightly hyperintense on T2-weighted image. The tumor was located on the left side of the spinal cord and was markedly enhanced after intravenous Gd-DTPA.

At the operation, a soft, dark-red mass was found situ-ated in the epidural space at the level of Th12 to which was totally removed. On histological examination, the tumor was shown to be mainly composed of mature fatty cells and of numerous blood vessels with enlarged lumens.

Postoperative course was uneventful and the symp-toms subsided during the following few months.