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はじめに
腺様囊胞癌(adenoid cystic carcinoma:ACC)は,1856年にBillrothらにより初めて円柱腫(cylindroma)として報告された腺癌の特異的1亜型であり,頭頸部腫瘍の1〜2%を占める。耳下腺,顎下腺などの大唾液腺に加え,口腔,鼻副鼻腔,口蓋,喉頭などの小唾液腺で発生するものが60〜70%と報告されているが,そのうち下咽頭における発生はきわめて稀である1〜3)。
今回われわれは,下咽頭に発生したACCの1症例を経験したので,若干の考察を加えてここに報告する。
A case of adenoid cystic carcinoma(ACC)arising in the hypopharynx is herein reported, which was defined as stage T4aN2bM0. Laryngeal preservation was possible under the influence of induction chemotherapy and definitive concurrent chemoradiotherapy using fluorouracil and carboplatin. Thereafter, following modified neck dissection, cervical nodal disease was controlled. Until now, because of close follow-up, there has not been any recurrence or metastasis.
Occurrence of ACC among hypopharyngeal carcinoma is very rare, with a rate of 0.3-0.8%. In this case, excellent results were achieved using preoperative chemotherapy and radiation, followed by neck dissection.
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