多発性頭蓋内腫瘤病変を合併した骨髄異形成症候群の１例

概要

論文の詳細を見る
A 70-year-old man was admitted to our hospital because of slowly progressive anemia and thrombocytopenia. He was diagnosed as having myelodysplastic syndrome (MDS) (FAB classification: refractory anemia with excess blasts in transformation, RAEB-T) by bone marrow examination. Because treatment with cytotoxic agents was not effective in improving the pancytopenia, pulse therapy using methylprednisolone was performed. After pulse therapy, marked leukocytosis appeared and was controlled by cytotoxic agents.One month after the pulse therapy,the patient experienced disorientation,headache and muscle weakness.A brain computed tomographic scan revealed multiple mass lesions in the cerebrum.No other malignancy except MDS was detected. Cerebrospinal fluid examination revealed an increase in leukemic blast cells in the fluid.He was therefore diagnosed as having metastasis of granulocytic sarcoma in the cerebrum,which was sensitive to a total cranial radiation therapy of 30Gy. MDS rarely complicates extra-medullary tumors before developing into acute leukemia.We presented here a rare case of MDS with multiple intracranial mass lesions which were sensitive to radiation.
信州医学会の論文
1999-10-10