診断が困難であった聴器痛の3症例—扁平上皮癌と腺癌

Diagnostic Problems of Ear Cancer: Report of Three Cases

　はじめに

　聴器の悪性腫瘍は稀であるばかりか，診断，治療に苦慮することが多く，一般にその予後は不良である。今回われわれは術前に確定的診断を得るのに苦慮した聴器癌を3例経験したので報告し，その診断について若干の考察を加える。

Case 1 is a 47-year-old male with the complaints of severe earache and otorrhea. HRCT demon-strated bone destruction around the tympanic cavity, however, repeated biopsy specimens ware not consistent with malignancy. Only after aural surgery, well-differentiated squamous cell carci-noma was revealed. Case 2 is a 44-year-old female complaining of left hearing loss. A white mass, behind the tympanic membrane in the posterior tympanic cavity, was first diagnosed as primary cholesteatoma by HRCT. The surgery revealed a soft fragile mass with the histopathological diagosis of adenocarcinoma. Case 3 is a 39-year-old male showing a mass in the external auditory canal with destruction of mastoid air cells. Total resection was performed, but final diagnosis was difficult because of its well-differen-tiated atypical cells. The possibility of rare ma-lignancies should be kept in mind when aural diseases were found.