脊髄軟膜下神経鞘腫の1例

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The patient, a 42-year-old female, was admitted with a 5-year history of progressive numbness of the bilateral lower limbs. Neurological examination disclosed left-sided weakness with hyperreflexia and hypesthesia under the Th_4 level. Metrizamide myelography showed a severe cord swelling from C_2 to C_7. Metrizamide CT scan revealed a severe cord widening at the C_<5.6>level and displacement of the cord and the anterior median fissure to the right side at the C_<6.7>level. In addition, an exophytic extension to the left side at the C_7 level was recognized. Laminectomy was performed from C_2 through Th_1. The tumor was located on the posterior surface of the spinal cord at the C_<4-6>levels and covered by the pia mater, and the left posterior root penetrated the tumor. Another tumor was found at the C_7 level, in accordance with the pre-operative CT scan finding. The tumors were totally removed. Histopathological examination revealed a typical Antoni type A schwannoma. This case was a sub-pial schwannoma originating from the posterior root entry zone. Usage of the term"sub-pial" has been coined with the lipoma located under the pia mater. Nevertheless, the authors proposed that the present case should be classified as the spinal sub-pial tumor.
日本脳神経外科学会の論文
1983-05-15