Neurological Surgery 脳神経外科33巻12号

2005年12月発行

症例

くも膜囊胞との鑑別が困難であった症候性Rathke's cleft cystの1例

著者： 光原崇文¹ 井川房夫¹ 大林直彦¹ 今田裕尊¹ 梶原洋介² 阿美古将¹ 鮄川哲二¹

所属機関： ¹島根県立中央病院脳神経外科 ²県立広島病院脳神経外科

ページ範囲：P.1213 - P.1218

Ⅰ．はじめに

　Rathke's cleft cystはトルコ鞍内に局在するもの，ないし鞍内から鞍上部に伸展した鞍上部伸展型がほとんど⁴⁾であり，鞍上部に限局したものはentirely suprasellar Rathke's cleft cystと呼ばれ，比較的稀^1,6,12)である．今回われわれは，くも膜下腔に沿って伸展し，くも膜囊胞との鑑別が困難であった症候性entirely suprasellar Rathke's cleft cystの1例を経験したので文献的考察を含め報告する．

参考文献

1）Barrow DL, Spector RH, Takei Y, Tindall GT：Symptomatic Rathke's cleft cysts located entirely in the suprasellar region：Review of diagnosis, management, and pathogenesis. Neurosurgery 16：766-772, 1985

2）Brassier G, Morandi X, Tayiar E, Riffaud L, Chabert E, Heresbach N, Poirier JY, Carsin-Nicol B：Rathke's cleft cysts：Surgical-MRI correlation in 16 symptomatic cases. J Neuroradiol 26：162-171, 1999

3）Cavallo AV, Murphy MA, McKelvie PA, Cummins JT：An epithelial cyst of the suprasellar region. Aust N Z J Surg 63：490-493, 1993

4）Cervoni L, Artico M, Salvati M, Carloia S：Rathke's cleft cyst：A clinical and radiographic review. Ital J Neurol Sci 18：37-40, 1997

5）Graziani N, Dufour H, Figarella-Branger D, Donnet A, Bouillot P, Grisoli F：Do the suprasellar neurenteric cyst, the Rathke cleft cyst and the colloid cyst constitute a same entity? Acta Neurochir (Wien) 133：174-180, 1995

6）Itoh J, Usui K：An entirely suprasellar symptomatic Rathke's cleft cyst：case report. Neurosurgery 30：581-584; discussion 584-585, 1992

7）Miyajima M, Arai H, Okuda O, Hishii M, Nakanishi H, Sato K：Possible origin of suprasellar arachnoid cysts：neuroimaging and neurosurgical observations in nine cases. J Neurosurg 93：62-67, 2000

8）Smith AR, Elsheikh TM, Silverman JF：Intraoperative cytologic diagnosis of suprasellar and sellar cystic lesions. Diagn Cytopathol 20：137-147, 1999

9）Starzyk J, Kwiatkowski S, Urbanowicz W, Starzyk B, Harasiewicz M, Kalicka-Kasperczyk A, Tylek-Lemanska D, Dziatkowiak H：Suprasellar arachnoidal cyst as a cause of precocious puberty--report of three patients and literature overview. J Pediatr Endocrinol Metab 16：447-455, 2003

10）Wang JC, Heier L, Souweidane MM：Advances in the endoscopic management of suprasellar arachnoid cysts in children. J Neurosurg Spine 100：418-426, 2004

11）Wenger M, Simko M, Markwalder R, Taub E：An entirely suprasellar Rathke's cleft cyst：Case report and review of the literature. J Clin Neurosci 8：564-567, 2001

12）弓削龍雄，重森　稔，徳富孝志，空閑茂樹，西尾暢晃，山本文人，徳永孝行，上垣正己，安陪等思，小島和行，倉本進賢：Entirely suprasellar symptomatic Rathke's cleft cystの2症例．No Shinkei Geka 19：273-278, 1991