硬口蓋を穿破した巨大な上顎洞血瘤腫症例

A case of giant maxillary hematocele destroyed the hard palate

はじめに

　上顎洞血瘤腫は1917年に田所^1）が報告した片側の上顎洞にみられる臨床上の疾患概念で，しばしば骨破壊を伴って悪性腫瘍との鑑別が困難なことがある^2）。今回，硬口蓋を広範囲に穿破した上顎洞血瘤腫症例を治療する機会を得たので，経過を報告するとともに，文献的考察を行った。

　A 64-year-old woman complained of a swelling of the left buccal and cervical lymph node swelling. CT revealed the mass that destroyed the walls of left maxillary sinus except for the orbital floor. The mass was diagnosed as not malignanct on biopsy from the lesion that protruded into the oral cavity. However, as the possibility of malignancy was assumed, we removed the mass with Weber-Fergusson approach and the ligation of external carotid artery. The intraoperative frozen section showed no tumorous lesion, and the extended resection was not performed. The definitive diagnosis was a hematocele of the maxillary sinus, and there have been no signs of recurrence.