頭蓋底手術を行った篩骨洞原発高分化型腺癌（腸管型）の1例

A Case of Intestinal-Type Adenocarcinoma of the Ethmoid Sinus Treated with the Skull Base Surgery

　はじめに

　前頭蓋底に浸潤した鼻・副鼻腔腫瘍に対して頭蓋底手術が行われるようになって10年以上が経ち，その有用性，遠隔成績^1）や予後因子^2）などが報告され，これらを加味した手術適応の判断が重要となってきている。

　今回，篩骨洞原発で前頭葉に浮腫を伴った高分化型腺癌（腸管型）に対して頭蓋底手術を行ったので報告する。

A 57-year-old man suffered from right epistaxis and right nasal obstruction. CT and MRI demon-strated a mass occupying the nose extending fromthe ethmoid sinus with bony defect of the anterior skull base and extensive edema of frontal lobe. Histological examination of biopsy specimen revealed well-differentiated papillary adenocarci-noma. We performed anterior craniofacial surgery and the tumor was completely resected. The patho-logical diagnosis was well-differentiated adenocar-cinoma (intestinal type, papillary-tubular cylinder cell type). There has been no evidence of recurrence at the time of this report.