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Neurological Surgery 脳神経外科42巻4号

2014年04月発行

文献概要

連載 脊椎脊髄手術に必要な基本的知識

(8)髄内腫瘍の診断と治療

著者: 寳子丸稔1

所属機関: 1信愛会脊椎脊髄センター

ページ範囲:P.363 - P.373

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Ⅰ.概  略

 脊髄腫瘍の発生率に関しては報告がほとんどないが,米国では10万人あたり年間0.74人と稀な腫瘍であることが報告されている54).その中でも髄内腫瘍は稀で,全脊髄腫瘍の18%16),あるいは硬膜内脊髄腫瘍の30%を占めるにすぎない55).髄内腫瘍の主なものには上衣腫,星細胞腫,血管芽細胞腫があり,全髄内腫瘍の90%以上を占める29).その他,稀なものとして上衣下腫60),脂肪腫19),過誤腫1),悪性リンパ腫34),乏突起神経膠腫48),胚芽腫27),悪性黒色腫43),転移性腫瘍5)などが報告されている.髄内腫瘍の中では上衣腫が最も多く,その発生頻度は髄膜腫に匹敵し,全髄内腫瘍の35~40%を占める16,54).星細胞腫と血管芽細胞腫の発生頻度は報告によりまちまちであるが,小児期では星細胞腫が髄内腫瘍の59%を占めて最も多いが,成人期では20%まで低下し2番目に多い髄内腫瘍であると欧米では報告されている52),しかしながら,日本ではさらに少なく,全髄内腫瘍の10%以下との報告もある16).血管芽細胞腫は全髄内腫瘍の2~15%と報告されている37).海綿状血管腫は腫瘍ではなく血管奇形に分類されることが多いが55),髄内腫瘍と同様の診断と治療方針をとるので,本稿では過去の報告にならって髄内腫瘍として扱う10,39).海綿状血管腫を髄内腫瘍として扱った場合,成人では全髄内腫瘍の5%,小児では1%を占めると報告されている10)

参考文献

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出版社:株式会社医学書院

電子版ISSN:1882-1251

印刷版ISSN:0301-2603

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