?胞型髄膜腫について

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Cystic meningioma is rare and the frequency is only about 1.2〜2.O% of all meningiomas in the literature. The authors experienced three cases of cystic meningioma. The first case was a 55-year-old male. He showed mental deterioration of 5 months duration. On admission he was apathetic and showed marked disorientation. Bilateral papilledema and the right pyramidal signs were also noticed. In CT scans, a well-defined homogenous high density area was seen in the left frontal lobe which was markedly enhanced. A well-circumscribed low density area was also seen in the center of the high density area. In the operation, exploratory puncture yielded 15 ml of xanthochromic viscous fluid. An elastic hard tumor was found attached to the left superior sagittal sinus and extended into the frontal lobe. The pathological diagnosis was meningocytic meningioma with a cyst. The second case was a 42-year-old female. She had suffered from headache and nausea for 3 months prior to admission. Neurological examination did not reveal any distinct deficit, but CT scan revealed a well-defined low density area in the right occipital region and a well-circumscribed high density area in the periphery of the lesion. In the operation, a large cyst was found, directly under the dura mater. About 30 ml of deep xanthochromic fluid was obtained by a puncture. The tumor, attached to the dura mater, was totally removed and the pathological diagnosis was meningocytic meningioma with an angioblastic component. The third case was a 30-year-old female whose complaints were headache and visual disturbance of 5 months duration. Except for bilateral papilledema, the neurological examination was normal. Neuroradiological examination indicated a left parietal mass lesion suggesting a cystic change. In the operation, about 25 ml of xanthochromic fluid was obtained by an exploratory puncture. The tumor was well-defined, elastic hard and attached to the falx. The pathological diagnosis was cystic meningioma of the transitional type. The clinical features, the pathogenesis of cyst formation and the diagnostic value of CT scans were discussed with a review of 37 cases reported in Japan. Location of the cystic meningioma was predominantly left-sided and most of these tumors were situated in the convexity. The pathogenesis of the cyst formation is still obscure although many theories have been proposed. Although diagnostic value of CT scans for cystic meningioma is very high, some cases are misdiagnosed as cystic gliomas. Clinical data and results of conventional neuroradiological examinations should also be taken into ac-count.
日本脳神経外科学会の論文
1981-08-15

?胞型髄膜腫について

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