側頭窩下に発生した横紋筋肉腫の治療経験

Rhabdomyosarcoma of the Infratemporal Fossa:Report of a Case

　はじめに

　鼻副鼻腔領域の横紋筋肉腫は比較的まれな悪性腫瘍であり，診断，治療に難渋する場合が多い。病理検査体制の進歩により病理学的診断に際しては早期に診断しえたものの側頭下窩というsilentareaに発生していたため患者の受診が遅れ，かなりの開口障害をきたしていた症例を経験した。術前化学療法および放射線療法の後，根治的手術を行ったが，治療に伴ういくつかの問題点を経験したので文献的考察を加えて報告する。

A case of rhabdomyosarcoma involving the infratemporal fossa in a 31-year-old man with one year history of trismus and a swelling of the right maxilla is presented. CT and MRI demonstrated a large tumor extending from the infratemporal fossa into the right maxilla. In-duction chemotherapy was initially instituted with VAC according to IRS protocol owing to this tumor's high probability of metastasis. A subsequent composite reduction with PMMC flap reconstruction of the oral cavity defect and a right radical neck dissection were performed. There was no evidence of recurrent or metastatic disease one year postoperatively.