Maekawa K, Ishida J, Kubo M, Kuriyama T, Fukuda F
No Shinkei Geka. 1975 Nov 10;3(11):955-9.
In 1972, Neault and his co-workers reported seven cases of uveitis associated with intracranial reticulum cell sarcoma. Recently we have experienced a similar case for the first time in Japan. A 32-year-old woman registered on March 10, 1971, complaining of blurred vision in the left eye for about two weeks. By ophthalmic examination, left posterior uveitis was diagnosed but the etiology was unknown. Treatment with corticosteroids was begun, but her left eye continued to fail in spite of the treatment. In August, 1971, she complained of weakness of left arm and leg, and in October, she suffered from severe headache and vomiting. At that time, uveitis appeared in the right eye too. Neurological findings and carotid angiogram indicated a right cerebral lesion. On November 5, 1971, a right frontoparietal craniotomy was performed but no tumor was found. Since then her neurological and eye symptoms had been progressively worse. The patient died on July 12, 1972. Postmortem examination revealed the tumor infiltrating in the bilateral diencephalon, left internal capsule, left lenticular nucleus, left temporal lobe, midbrain, pons, left dentate nucleus, optic chiasma and intracranial portion of the optic nerves. But no tumor was found at any other parts of the body. Histologically the tumor was a reticulum cell sarcoma. The eyeballs were not examined histologically, but the uveitis in this case was thought to be closely related to the intracranial reticulum cell sarcoma. If the uveitis is resistant to the treatment, we must consider a possibility of reticulum cell sarcoma of the brain.
1972年,尼奥尔特及其同事报告了7例与颅内网状细胞肉瘤相关的葡萄膜炎病例。最近,我们在日本首次遇到了类似病例。一名32岁女性于1971年3月10日前来就诊,主诉左眼视力模糊约两周。经眼科检查,诊断为左后葡萄膜炎,但病因不明。开始用皮质类固醇进行治疗,但尽管如此,她的左眼病情仍持续恶化。1971年8月,她主诉左臂和左腿无力,10月,她出现严重头痛和呕吐。此时,右眼也出现了葡萄膜炎。神经学检查结果和颈动脉血管造影显示右侧脑部有病变。1971年11月5日,进行了右额顶开颅手术,但未发现肿瘤。从那时起,她的神经和眼部症状逐渐恶化。患者于1972年7月12日死亡。尸检发现肿瘤浸润双侧间脑、左侧内囊、左侧豆状核、左侧颞叶、中脑、脑桥、左侧齿状核、视交叉和视神经颅内段。但身体其他部位未发现肿瘤。组织学检查显示该肿瘤为网状细胞肉瘤。未对眼球进行组织学检查,但认为该病例中的葡萄膜炎与颅内网状细胞肉瘤密切相关。如果葡萄膜炎对治疗有抵抗性,我们必须考虑脑网状细胞肉瘤的可能性。