顔面神経麻痺をきたしたワルチン腫瘍の2症例

Warthin's tumor associated with facial nerve palsy

Ⅰ．はじめに

　耳下腺腫瘍は頭頸部腫瘍の約5％を占める腫瘍で，良性腫瘍が約80％，悪性腫瘍は約20％の発生頻度であると報告されている^1,2）。病理学的分類では多形腺腫が最も多く耳下腺良性腫瘍の55～75％を占め，次にワルチン腫瘍が多く耳下腺良性腫瘍の15％～37％を占めている^2～5）。ワルチン腫瘍は悪性化することがほとんどなく，腫瘍核出術などの小規模な手術で対応する場合もある。

　術前所見の中でも顔面神経麻痺の合併は悪性腫瘍を強く示唆する所見であり，良性腫瘍では術前に顔面神経麻痺を合併することは一般的に稀である。今回われわれは，顔面神経麻痺を伴ったワルチン腫瘍を経験したので文献的考察を加えて報告する。

　Benign parotid tumors rarely cause facial nerve palsy. We experienced 2 patients who presented with facial nerve palsy among 102 consecutive cases of Warthin's tumor in the past 20 years. The site of occurrence was the parotid gland in all 102 cases. The patients were an 82-year-old woman and a 53-year-old man without particular past history of illness. Acute local inflammation and rapid expansion of the tumor were thought to have impaired the facial nerve in both cases. After resection of the tumor and administration of antibiotics,partial and complete recoveries were eventually achieved in the former and latter cases,respectively. We must be aware that facial nerve palsy may be associated even with benign parotid tumors including Warthin's tumor.