上顎洞悪性腫瘍を疑ったいわゆる血瘤腫2症例

Two Cases of Hemangioma of the Maxilla suspected as Malignant Tumor

はじめに

　鼻・副鼻腔に発生する腫瘍は悪性腫瘍が約70％を占め，良性腫瘍は比較的少なく，しかもそのうち約1／4が血管に由来した腫瘍である。いわゆる血瘤腫は1917年田所^1）によって命名された臨床的な診断名で良性疾患を意味するが，現在でもその本態は明確ではなく，臨床的に悪性腫瘍との鑑別が困難な症例もある。そこで最近経験した血瘤腫の症例を報告するとともに，その成因と治療について若干の考察を述べる。

Two cases of maxillary hemangioma (hematoma) with massive bone destruction were reported. First case, a 19-year-old male, had complained of nasal bleeding, nasal obstruction, and a cheek swelling. Second case, a 78-year-old male, had complained of nasal obstruction and bleeding. Tentative diagnosis was maxillary cancer, but biopsy of the lesion in the nasal cavity showed hematoma with necrosis and non specific granu-lomatosis. The first patient was treated with partial maxillectomy and postoperative irradiation. The second patient was treated with radical operation. Histological examination revealed no evidence of malignant change but massive hema-toma and necrosis with a part of hemangioma-like lesion. It is difficult to distinguish such lesion from malignant tumor, and careful examination with a long term follow-up is necessary.