頭蓋内進展の著しいadenoid cystic carcinoma の1例

Adenoid Cystic Carcinoma with Striking Intracranial Extension : A Case Report

　Ⅰ．はじめに

　腺様囊胞癌adenoid cystic carcinomaは，主として大小唾液腺に発生する悪性腫瘍である．一般的に発育は緩慢で長い経過が特徴であるが，局所再発を来し遅発性に神経組織に沿い頭蓋底に浸潤性発育や，稀に血行性に遠隔転移する．

　今回われわれは，外耳道耳垢腺より発生したadenoid cystic carcinoma根治術後，約8年の経過にて原発巣の再発なく同側中頭蓋窩に転移した症例を経験したので文献的考察を加え報告する．

　We report a case of intracranial adenoid cystic carcinoma in the middle cranial fossa. A 40-year-old woman had noticed a tumor in the left external auditory canal 8 years previously. It was totally resected at that time. Histologically,the tumor was diagnosed as an adenoid cystic carcinoma. Recently the patient presented with loss of consciousness,suffering from mild recent-memory disturbance. Neurological examination revealed no other abnormalities. Magnetic resonance imaging (MRI) demonstrated an enhanced solid mass with a multicystic component in the left temporal lobe. She underwent subtotal removal of the tumor. It was well-demarcated,and was confirmed to be adhesive to the dura matter of the middle cranial fossa. Histology of the tumor was the same as it was 8 years ago. She was discharged from our hospital without neurological deficits. Two months after surgery,gamma knife radiosurgery was performed against the residual tumor.