繰り返す脳出血を呈した頭蓋内原発血管肉腫の１例

• Published in: Neuro-Oncologyの進歩 Vol. 22; no. 1; pp. 26 - 30
• Main Authors: 亀井, 孝昌, 大重, 英行, 淺井, 昭雄, 武田, 純一, 近藤, 智正, 吉村, 晋一
• Format: Journal Article
• Language: English
• Published: 近畿脳腫瘍病理検討会 2015; Kinki Brain Tumor Pathology Conference
• Subjects: angiosarcoma; intracerebral hemorrhage; primary Central Nervous System(CNS)tumors
• ISSN: 1880-0742; 2187-0551
• DOI: 10.11452/neurooncology.22.1_26

Primary central nervous system(CNS)angiosarcoma is extremely rare. Thirty three patients with primary CNS angiosarcoma have been reported. Here we report a 69-year-old man with a subcortical hematoma in the left temporal lobe. Magnetic resonance imaging(MRI)showed an enhanced nodule in the hematoma cavity. We performed an initial operation to evacuate the hematoma and the nodule; however, 3 hours later hematoma volume increased and intraventricular hemorrhage was observed. A second operation was performed to evacuate the hematoma and the residual nodule. After 3 weeks, a computed tomography(CT)scan showed an asymptomatic lesion, specifically oozing hematoma in the cavity; therefore we selected conservative therapy.Microscopically, the tumor cells showed an abortive vascular structure, and positive immunohistochemical staining for cluster of differentiation(CD)31, CD34, and p53. Systematic screening by CT examination did not detect any mass lesion except the brain tumor. Finally we diagnosed primary CNS angiosarcoma, and adjuvant radiation therapy was performed.We suggest the en-bloc removal of primary CNS angiosarcoma to prevent rebleeding.