悪性髄膜腫を含む四重癌の1剖検例

An Autopsy Case of Four Primary Cancers including Malignant Meningioma

　68歳，男性，早期食道癌・早期胃癌・肺癌．悪性髄膜腫の四重癌の1剖検例を経験した。四重癌以上の重複癌を1974年から1989年まで16年間の日本病理剖検輯報について調べると156例の記載があり，近年増加の傾向が明瞭である。好発臓器は胃，大腸，肺，前立腺，肝臓および食道などの順であり，本剖検例の胃癌，肺癌および食道癌は発生頻度の高い臓器に属していた。しかし，悪性髄膜腫の合併は極めて少なく，僅か2例を数えるのみであった。従って現在の所，本剖検例は悪性髄膜腫を含む四重癌以上の重複癌の第3例目と思われる。悪性髄膜腫を含む重複癌は極めて稀であるが，本剖検例のごとく他癌による死亡であっても頭部の検索が行えれば，その頻度は増す可能性がある。

The authors describe an autopsy case of a 68-year -old man with four primary cancers diagnosed at autopsy including malignant meningioma, early esophageal cancer, early gastric cancer and lung cancer. Recently, the number of patients with four and five primary cancers has been increasing. According to the Annual of the Pathological Autopsy Cases in Japan, 156 cases were reportedduring 16 years from 1974 to 1989. In this series, cancers were detected most freqently in stomach, colon, lung, prostate, liver and esophagus. However, only two cases with four and five primary cancers including malignant meningioma were reported.

Because occult cancers like prostatic cancers are unexpectedly diagnosed at autopsy, the incidence of four and five primary cancers including malignant meningioma seems to be higher when the central nervous system is examined more frequntl at autopsy.