上顎骨骨肉腫の治療経験

Osteosarcoma of the Maxilla:Report of a Case

　緒言

　骨肉腫は骨原発悪性腫瘍のなかでは骨髄腫に次いで多いものの，顎骨における発生は全体の1割に満たず比較的まれである^1〜7）。一般に極めて悪性度の高い疾患であるが，好発部位である長管骨原発骨肉腫に比べ，顎骨原発骨肉腫は好発年齢が高いこと，遠隔転移率が低いことなどの点で異なった臨床病態を呈する^2〜8）。今回，われわれは左上顎骨に発生した骨肉腫症例に対し，外科的治療単独の局所制御により良好な経過を得ているので，考察を加え報告する。

A case of osteosarcoma in the maxilla of a 34 -year—old female was reported. Pathological diag-nosis was not confirmed by either incisional biopsy or Denker's maxillotomy specimen. The definitive diagnosis of osteosarcoma was obtained after par-tial resection of the palate. Local recurrence was noted 11 months later, then immediately an ex-tended total maxillectomy was performed with coronal incision and infratemporal fossa approach. There needed no supplementary treatment because of free surgical margin from tumor cells and no evidence of metastasis. There were no signs of recurrence nor metastasis for 2 years after the last surgery.