蝶形骨洞癌の2症例

Sphenoid Sinus Carcinoma:Report of Two Cases

　緒言

　副鼻腔に発生する悪性腫瘍は，そのほとんどが上顎洞原発であり，蝶形骨洞原発のものは非常に稀である。われわれの検索し得た範囲では，蝶形骨洞原発の悪性腫瘍の報告は，本邦で28例，欧米でも44例を認めるに過ぎない。蝶形骨洞原発の腫瘍は，洞内にとどまっている間は症状を現わさず，洞外に進展して初めて症状を呈するため早期発見が難しい。また蝶形骨洞周囲には，視神経，動眼神経，三叉神経，滑車神経などの脳神経や海綿静脈洞，さらには大脳が隣接しているため，治療も難しく極めて子後が悪い。今回われわれは，蝶形骨洞原発の扁平上皮癌の2例を経験したので，若干の文献的考察を加えて報告する。

The first case was a 39-year-old male with chief complaints of left tinnitus and headache. He had left trigeminal nerve palsy. The sphenoid sinus was occupied by a tumor which was con-firmed by x-ray tomography. This patient received combination therapy of surgery, irradiation and chemotherapy. Seven years later, he died of lung and brain metastases.

The second case was a 51-year-old male with chief complaints of headache and bilateral visual disturbance. Right I, II, III, IV, VI cranial nerve palsy and left optic nerve palsy were confirmed. Chemotherapy, irradiation and surgery were conducted. He died of bleeding from the tumor 8 months after the initial treatment.