小唾液腺由来の多形腺腫内癌の1症例

A Case of Carcinoma in Pleomorphic Adenoma Arising from the Minor Salivary Gland

　はじめに

　多形腺腫は耳下腺，顎下腺などの大唾液腺に好発し，口腔粘膜に散在する小唾液腺にも発生する。本腫瘍は通常，被膜に包まれて膨張性に増殖し良性腫瘍とみなされるが，ときに上皮性細胞成分が悪性化することがある。悪性化したものは多形腺腫内癌と呼ばれ，浸潤性増殖や転移などの性質を示す。

　今回われわれは，小唾液腺由来の多形腺腫内に腺癌と扁平上皮癌が同時期に発生した症例を経験したので，若干の文献的考察を加えて報告する。

A 58-year-old man had a mass in his right buccal mucosa for 23 years. The mass was growing rapidly and became painful in the last 4 months before he was referred to our hospital. CT scan revealed a 5×4 cm tumor extending to the parapharyngeal space with the bone destruction of the maxilla. He under-went a modified radical neck dissection, tumor resection combined with partial maxillectomy and segmental mandibulectomy, and reconstruction using fibular osseocutaneous flap and rectus ab-dominis musculocutaneous flap. Pathological diag-nosis of the surgical specimen was adenocarcinoma and squamous cell carcinoma in pleomorphic adenoma. The patient is currently free from the disease 2 years after surgery.