鼻中隔に発生した鼻腔神経線維腫の1例

A case of nasal neurofibromatosis occurring in the nasal septum

はじめに

　耳鼻咽喉科領域における神経原性腫瘍のうち鼻・副鼻腔に発生するものは比較的稀であり，神経線維腫の発生は非常に稀と考えられている^1）。

　今回われわれは，鼻閉・後鼻漏を主訴に受診し，術前に神経線維腫の診断となり，手術加療を行い，良好な経過をたどった孤立性神経線維腫の1例を経験したため報告する。

　Odontogenic tumors in the paranasal sinuses are relatively rare. We present a case of isolated neurofibromatosis in a 44-year-old woman with nasal congestion and post-nasal drip. Intranasal findings showed a white-toned mass with elastic, hard, smooth-surfaced vasodilation that filled the left total nasal passage. MRI showed occupying lesions with a smooth surface of 21×8×21 mm from the nasal vestibule to the anterior end of the middle turbinate, T1 hypointensity, central hypointensity at T2, and marginal hyperintensity. Preoperative biopsy revealed spindle-shaped cells and nerve tissue, and S-100 protein was detected. Therefore, a diagnosis of nerve fiber type was made, and excision was performed under general anesthesia, followed by a good course without recurrence.

　It is important to treat neurogenic tumors based on the risk of malignancy and residual risk, and those that occur in the nasal sinuses may be diagnosed via preoperative biopsy, including neurofibroma. For nasal sinus tumors suggestive of being malignant, it is important to perform a biopsy before surgery and to plan sufficient resection.