頭蓋内Adenoid Cystic Carcinoma—2症例について

INTRACRANIAL ADENOID CYSTIC CARCINOMA:Report of two cases

I．はじめに

　この腫瘍は，1859年，Billroth^4）によつて，cylindromという名で発表され，その後，種々の名称で報告がなされている。その発生部位は，唾液腺，鼻腔・副鼻腔，気管などであり，臨床的には，耳鼻科領域からの報告が多い。これが，頭蓋底あるいは，頭蓋内に浸潤，転移し神経症状を呈することは比較的少なく，まして脳神経外科的処置の行なわれることはまれである。

　最近，われわれは，脳神経症状を主訴として，来院し開頭を行ない腫瘍を摘出し，組織学的に確認した頭蓋底adenoid cystic carcinomaの症例を経験したので報告する。この例は，初発症状が神経症状であつて，十分な検索にもかかわらず，原発巣が不明であり，まれな経過をとつた例である。

Two cases of intracranial, so-called, adenoid cystic carcinoma were reported. The first case, a 42-year-old male, had palsies of fifth, sixth, seventh and eighth cranial nerves and the destruction of the apex of the pyramid was found by the roentogeno-graphic study. Performing suboccipital craniectomy, the tumor was removed and was verified histolo-gically. He was treated by ⁶⁰Co irradiation post-operatively, totally 4,500r in tumor dosis. The primary tumor could not be found even by further otological examinations.

The second case was a 41-year-old male who had the history of the malignant submandibular tumor which was removed 8 years before. The solitary metastatic tumor was found in the right frontal lobe and was totally removed.

It is rare that the intracranial adenoid cystic carcinoma was succesfully removed. And in addi-tion to this, the first case is very rare, in the point that the tumor seems to be primary, at least from decision of clinical data.