耳下腺内リンパ節転移を初発症状とした上咽頭癌の1例

A case of nasopharyngeal carcinoma metastasized to lymph node in the parotid gland

Ⅰ　はじめに

　上咽頭癌は早期にリンパ節転移をきたしやすく，上咽頭癌の初発症状の70％は頸部リンパ節腫脹といわれている^1）。また，上咽頭癌は解剖学的に原発巣が発見されにくく進行癌として発見されることが多い^2）。

　今回われわれは，当初，耳下腺扁平上皮癌と考え手術を行ったが，臨床経過から，耳下腺内リンパ節転移を初発症状とした上咽頭癌と考えられた，稀な1例を経験したので，文献的考察を加えて報告する。

　Most of nasopharyngeal carcinoma presented a swelling of cervical lymph node. A 48-year-old man with nasopharyngeal carcinoma first metastasized to lymph node in the parotid gland was presented. The patient presented with a swelling of the right parotid,though there was no tumor in the naso pharynx. The tumor was removed by parotidectomy,and squamous cell carcinoma was diagnosed. The tumor appeared in the naso pharynx and cervical lymph node 3 months after operation and postoperative radiation. The mass was extremely decreased in size by chemoradiotherapy. Afterwards,the patient was treated by oral chemotherapy for 5 years. After 7 years the tumor was completey controlled with no evidence of metastasis and side effect.