反復する顔面神経麻痺を呈した急性骨髄性白血病の1症例

Recurrent facial palsy in a patient with acute myeloid leukemia：A case report

Ⅰ．はじめに

　白血病の経過中に難聴や耳鳴，顔面神経麻痺などの耳科学的症状が生ずるということはよく知られている^1,2）。さらに近年の化学療法の進歩とともに白血病の長期生存症例も増加した結果，骨髄中に白血病細胞の存在しない完全寛解期に側頭骨内に再発を認めたという報告も散見される^3）。今回，われわれは急性骨髄性白血病（以下，AMLと略す）の寛解期に顔面神経麻痺を反復し，乳突削開術による生検で白血病再発の確定診断を得ることができた症例を経験したので報告する。

　A 17-year-old man was diagnosed of acute myeloid leukemia（AML）. Chemotherapies led him hematological remission. However he had right facial palsy twice, CT scans and MRI suggested a lesion close to the mastoid portion of the facial nerve in the mastoid. Bone marrow biopsy did not reveal recurrence of AML. Mastoidectomy and open biopsy showed relapse of AML.

　The patient underwent combined therapies：chemotherapy, radiation, and bone marrow transplantation, and his facial palsy was recovered completely without synkinesis.

　We conclude that we have to pay much attention to recurrent AML in patients with facial palsy who had a personal history of AML, even though in a period they are having hematological remission.