鼻腔悪性腫瘍の臨床的検討

Malignant Tumors of the Nasal Cavity

I．はじめに

　鼻腔に発生する悪性腫瘍は多彩な病理組織型を呈するが，TNM分類は副鼻腔の分類しかなく，鼻腔の分類は未だ確立されていない。また，治療方針も病理組織型および腫瘍の浸潤範囲によって手術療法，化学療法，放射線療法の単独あるいは組み合わせで行われているが，確立されたものはなく治療上検討すべき点を少なからず残している。

　今回われわれは，過去15年間に一次治療を行った鼻腔悪性腫瘍12症例を臨床的に検討したので，若干の文献的考察を加えて報告する。

　Primary malignant tumors of the nasal cavity are relatively rare. Twelve cases（9 males and 3 females） with malignant tumors of the nasal cavity underwent curative treatment between 1986 and 2001. Histologically,there were 3 with olfactory neuroblastoma,2 squamous cell carcinoma,2 adenoid cystic carcinoma,1 malignant melanoma,1 metastatic hepatic cell carcinoma,1 adenocarcinoma,1 sarcoma and 1 undifferentiated carcinoma. All twelve cases underwent multidisciplinary treatment including surgery,irradiation and chemotherapy. The cause-specific two-year survival rate and the cause-specific five-year survival rate were 72.2％ and 60.2％ respectively. Two cases underwent reconstructive operation with a forehead flap. Death due to malignant tumors of the nasal cavity occurred in 4 cases,as follows：local recurrence in 1 case and distant metastasis in 3 cases. Treatment of distant metastasis should be further examined as a factor that may lead to improvement of the outcome of this disease.