上顎全摘出術を要した鼻・副鼻腔内反性乳頭腫の1例

A Case of Sinonasal Inverted Papilloma Requiring Total Maxillectomy

　はじめに

　乳頭腫は，病理組織学的に外反性乳頭腫，内反性乳頭腫および円柱上皮乳頭腫に分類され，臨床的にもそれぞれ特徴的な性格を有している^1）。中でも内反性乳頭腫は，臨床的には局所再発を高頻度に認め，悪性腫瘍の合併や悪性化の可能性があるという点で注意を要する良性腫瘍である。

　今回われわれは，臨床的に悪性化が疑われ，上顎全摘出術を要した内反性乳頭腫の1例を経験したので，若干の文献的考察を加えて報告する。

Inverted papilloma should be drawn attention because it shows high local recurrence rate and is occasionally associated with a concurrent malignant tumor or becomes malignant. A 57-year-old male underwent Caldwell-Luc procedure for inverted papilloma in the right maxillary sinus. He visited the hospital again ayear later because he was suffering from the right nasal obstruction.

At the first examination, CT showed a massive bone destruction around the maxillary sinus and hardpalate suggesting concurrence of malignancy. He underwent total maxillectomy due to extensive bone destruction, but biopsy of the tumor specimen revealed no concur-rent tumor.

Pathologically, the specimen showed no malignant fea-ture but severe infiltration of papilloma into the sur-rounding bone tissue. No recurrence was not noted at 13 months after operation.