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Neurological Surgery 脳神経外科48巻6号

2020年06月発行

文献概要

症例

大量出血で発症した右後頭葉放射線壊死の1例—病理組織学的検討

著者: 髙木友博1 継仁1 平田陽子2 吉岡努1 土持廣仁3 井上亨4

所属機関: 1福岡赤十字病院脳神経外科 2福岡大学筑紫病院脳神経外科 3つちもち脳神経外科・内科クリニック 4福岡大学医学部脳神経外科

ページ範囲:P.541 - P.546

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Ⅰ.はじめに
 放射線治療は,頭蓋内腫瘍や転移性脳腫瘍,脳血管奇形に対して行われる標準治療法の1つである.放射線治療後の遅発性合併症として,髄膜腫や海綿状血管腫などの放射線誘発腫瘍の発生や遅発性放射線壊死が知られている.放射線治療後の脳出血の原因は,一般に海綿状血管腫からの出血報告が多いと言われている3)
 今回われわれは,放射線治療後18年経過して大量出血で発症した症候性遅発性放射線壊死を経験した.遅発性放射線壊死を伴う出血例は珍しく,病理学的検討を加え報告する.

参考文献

1) Cha YJ, Nahm JH, Ko JE, Shin HJ, Chang JH, Cho NH, Kim SH:Pathological evaluation of radiation-induced vascular lesions of the brain:distinct from de novo cavernous hemangioma. Yonsei Med J 56:1714-1720, 2015
2) Cheng KM, Chan CM, Fu YT, Ho LC, Cheung FC, Law CK:Acute hemorrhage in late radiation necrosis of the temporal lobe:report of five cases and review of the literature. J Neurooncol 51:143-150, 2001
3) Cutsforth-Gregory JK, Lanzino G, Link MJ, Brown RD Jr, Flemming KD:Characterization of radiation-induced cavernous malformations and comparison with a nonradiation cavernous malformation cohort. J Neurosurg 122:1214-1222, 2015
4) Fisher AW, Holfelder H:Lokales amyloid im gehirn. Dtsch Z Chir 227:475-483, 1930
5) Furuse M, Nonoguchi N, Kawabata S, Miyatake S, Kuroiwa T:Delayed brain radiation necrosis:pathological review and new molecular targets for treatment. Med Mol Morphol 48:183-190, 2015
6) Hegde AN, Mohan S, Lim CC:CNS cavernous haemangioma:“popcorn” in the brain and spinal cord. Clin Radiol 67:380-388, 2012
7) Kawano H, Sato K, Hosotani K, Kubota T, Goya T, Arikawa S, Wakisaka S:Repeating hemorrhage with a long duration after radiotherapy for glioma:radiological and histological observations. Noshuyo Byori 13:85-92, 1996
8) Kleinschmidt-DeMasters BK, Lillehei KO:Radiation-induced cerebral vascular “malformations” at biopsy. J Neuropathol Exp Neurol 75:1081-1092, 2016
9) Minniti G, Clarke E, Lanzetta G, Osti MF, Trasimeni G, Bozzao A, Romano A, Enrici RM:Stereotactic radiosurgery for brain metastases:analysis of outcome and risk of brain radionecrosis. Radiat Oncol 6:48, 2011
10) Mitsuya K, Watanabe J, Nakasu Y, Hayashi N, Harada H, Ito I:Expansive hematoma in delayed cerebral radiation necrosis in patients treated with T-DM1:a report of two cases. BMC Cancer 16:391, 2016
11) Nonoguchi N, Miyatake S, Fukumoto M, Furuse M, Hiramatsu R, Kawabata S, Kuroiwa T, Tsuji M, Fukumoto M, Ono K:The distribution of vascular endothelial growth factor-producing cells in clinical radiation necrosis of the brain:pathological consideration of their potential roles. J Neurooncol 105:423-431, 2011
12) Osborn AG, Salzman KL, Barkovich AJ(eds):Diagnostic Imaging-Brain, 2nd ed. Amirsys Press, Canada, 2010, pp.30-33
13) Oyoshi T, Hirahara K, Uetsuhara K, Yatsushiro K, Arita K:Delayed radiation necrosis 7 years after gamma knife surgery for arteriovenous malformation--two case reports. Neurol Med Chir(Tokyo)50:62-66, 2010
14) Patel U, Patel A, Cobb C, Benkers T, Vermeulen S:The management of brain necrosis as a result of SRS treatment for intra-cranial tumors. Transl Cancer Res 3:373-382, 2014
15) Woo E, Chan YF, Lam K, Lok AS, Yu YL, Huang CY:Apoplectic intracerebral hemorrhage:an unusual complication of cerebral radiation necrosis. Pathology 19:95-98, 1987
16) Zabramski JM, Wascher TM, Spetzler RF, Johnson B, Golfinos J, Drayer BP, Brown B, Rigamonti D, Brown G:The natural history of familial cavernous malformations:results of an ongoing study. J Neurosurg 80:422-432, 1994

掲載誌情報

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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