レントゲン癌の1例

SQUAMOUS CELL CARCINOMA IN CHRONIC RADIODERMATITIS

I．緒言

　慢性放射線皮膚炎に発生する悪性腫瘍はほとんど有棘細胞癌である^1）。最近著者らが経験したレントゲン癌の症例もその組織所見は有棘細胞癌であつたが，極めて多様なBroders^2）の悪性度分類に従えば1度から4度に亘る像を示した点，我々の興味を引いたのでここに組織所見を中心として症例の概略を報告する。

Almost all roentgen carcinomas belong to the squamous cell type which usually show Bro-der's grade 2 or 3, but not infrequently some show a picture of spindle-shaped cell sarcoma.

A case of roentgen carcinoma in a 53-year-old male bone-setter was reported. He began to use a roentgen apparatus for bone-setting 18 years ago, and has used it for 12 years. The left hand was mainly exposed to x-ray. Lesions of chronic radiodermatitis appeared 10 years ago and became partly verrucous 6 years ago. The verrucous lesions showed ulceration on the left 2nd and 3rd fingers.

At his first visit, a walnut-sized tumor with central ulceration on the dorsal aspect of the left 3 rd finger and a thumb-nail-sized, crater-formed ulcer on the palmar surface of the left 2nd finger were proved. The extensor surface of both hands showed chronic radiodermatitis.

Histologic specimen from the tumor on the left 3rd finger showed squamous cell carcinoma of Broder's 2nd and 3rd grades. That from the ulcer on the left 2nd finger was composed of squamous cell carcinoma of Broder's 1st grade and fibro-sarcomatous changes. Polymorphism of the histologic picture in this case was noteworthy.

Amputation of the two fingers and extirpation of the left cubital and axillary lymph nodes were performed. Thereafter metastases were proved in the regional lymph nodes.