硬口蓋に進展した上顎洞血瘤腫の1例

A case of organized hematoma of the maxillary sinus extending to the hard palate

はじめに

　血瘤腫は，上顎洞など副鼻腔の閉鎖腔に何らかの原因で出血と器質化が繰り返され腫瘤が形成される病態であり，病理学的には腫瘍ではなく臨床的疾患名である。鼻出血，鼻閉，頰部腫脹などの症状を伴い，画像検査では骨欠損を認めることもあるため，悪性腫瘍との鑑別が重要である。今回われわれは，上顎洞に発生して硬口蓋に進展し悪性腫瘍と鑑別が困難であった血瘤腫を経験したので，若干の文献的考察を加えて報告する。

　We report a case of an organized hematoma of the maxillary sinus extending to the hard palate. A 70-year-old man with hypertension was admitted to the otolaryngology department for epistaxis and toothache. Computed tomography revealed an expansive mass lesion with bone destruction in the left maxillary sinus. Biopsy was performed, but the pathological findings showed no significant changes in the paranasal mucosa. Magnetic resonance imaging showed that the mass was well demarcated from the surrounding structures, and it was radiologically diagnosed as an organized hematoma. Preoperative embolization was performed, and the mass was removed transmaxillarily and endonasally. Pathological examination confirmed that the mass was an organized hematoma.