多発性頭蓋内epidermoidの1例 : 脳幹内epidermoidと中頭蓋窩epidermoidの合併例

概要

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A case of multiple intracranial epidermoids is reported. A 38-year-old woman who had a three-year history of hemihypesthesia on the right side of her body, diplopia, gait disturbance, dysarthria, and visual field defect, was admitted. Neurological examination revealed right hemiparesis, bilateral abducens palsies, and cerebellar dysfunction. A computed tomography (CT) scan demonstrated a huge low density area in the left middle cranial fossa and heterogeneous density area in the brain stem. She was diagnosed tentatively as epidermoid in the middle fossa and intraaxial mass of the brain stem. Surgery was performed twice. In the first operation, the temporal mass was removed subtotally. Secondarily, only suboccipital craniectomy was performed. After the second operation, her condition deteriorated due to recurrent aseptic meningitis and aspiration pneumonia. She died three months later. Autopsy revealed that an epidermoid was situated in the brain stem intraaxially and another epidermoid was located in the temporal region independently. An intraaxial epidermoid is a rare entity, especially in the brain stem. There is no report of multiple intracranial epidermoids in the literature. The authors emphasize the necessity to rule out epidermoid, when CT shows a high or heterogeneous density area, even if multiple and/or contrast enhanced.
日本脳神経外科学会の論文
1985-05-15