高齢者の上顎洞に発生した癌肉腫の1例

So-called carcinosarcoma of the maxillary sinus

はじめに

　癌肉腫は癌腫成分と肉腫成分が同一腫瘍内に存在する稀な悪性腫瘍である。頭頸部領域では喉頭，甲状腺に多いことが報告されており^1），上顎洞に発生することは比較的稀である。癌肉腫は癌腫と肉腫が別々に同一腫瘍内に発生した真性癌肉腫と，癌腫成分の一部が二次的に肉腫様に変化したいわゆる癌肉腫の2つに大別される^2）。今回われわれは高齢者の上顎洞に発生したいわゆる癌肉腫の1例を経験したので，文献的考察を加えて報告する。

　A 90-year-old female presented with a chief complaint of left cheek discomfort. Computed tomography before the initial treatment showed a primary tumor with destruction of the anterior wall of the left maxillary sinus. Histological examination of the primary tumor revealed two components of epithelial tumor cells and mesenchymal tumor cells. This tumor was diagnosed to be so-called carcinosarcoma based on the findings of immunohistochemical staining.

　We performed radiation therapy and concurrent superselective intra-arterial chemotherapy using cisplatin（50 mg/body, biweekly）. As the result, the tumor volume has been decreased in the primary site. Tumor recurrence had occurred around the cavernous sinus and the patient eventually died due to general prostration.