脊椎管内に神経節腫の再発を来した Dumbbell 型神経芽細胞腫の1例

概要

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A girl of two years and 9 months was addmitied to our hospital with disturbance ol eyesight. Close examinations revealed dumbbell type-neuroblastoma with metastasis to the head and femur bone, sphenoid bone, and abdominal skin (Stage 4A). After the chemotherapy of the A1 protocol and radiation therapy for the metastatic lesion of the head bone, intraspinal and metastatic lessions disappeared on imaging studies. And then resection of the primary tumor at the retroperitoneal cavity was performed. Microscopic examination revealed a well differentiated type of ganglioneuroblastoma in the primary tumor. Auto bone marrow transplantation was then performed. Recurrent tumor in the spinal canal was detected on CT scan two years and 8 months after initiation of treatment. Laminotomy and resection of intraspinal tumor were performed immediately. Microscopic examination of the spinal tumor revealed ganglioneuroma, Neuroblastoma is notable for its ability to spontaneously regress and in some instances, to differentiate to less malignant ganglioneuromas. This is sometimes found after chemotherapy or radiation therapy. We speculated that in this case, ganglioneuroblastoma differentiated into a mature ganglioneuroma in the spinal canal by chemotherapy.
日本小児外科学会の論文
1991-12-20