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はじめに
若年発症の上咽頭癌はほとんどの組織型が非角化型扁平上皮癌未分化型で,放射線感受性が高いことが知られている1).また,Epstein-Barr virus(EBV)との関連も示されており,EBV-encoded small RNA(EBER)陽性例は予後良好であることが報告されている2).今回,若年発症のEBER陽性上咽頭癌に対し,化学放射線療法で局所制御可能であったものの,治療後きわめて早期にびまん性肝転移をきたし死亡した症例を経験した.本症例の経過とともに文献的考察を加えて報告する.
A 27-year-old man was initially diagnosed with undifferentiated nasopharyngeal carcinoma (cT3N3M0) and underwent concurrent chemoradiotherapy. The primary tumor and right lymph nodes disappeared after treatment. Although adjuvant chemotherapy was planned, the patient rapidly developed liver failure and died 46 days after chemoradiotherapy due to diffuse liver metastasis.
This type of nasopharyngeal carcinoma is most common among young patients and is highly sensitive to radiation; however, distant metastasis results in a poor prognosis. Early detection of distant metastases is crucial, and induction chemotherapy and the measurement of plasma EBV DNA levels can be helpful.

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