化膿性骨髄炎を引き起こした前頭洞扁平上皮癌の1例

Squamous Cell Carcinoma of Frontal Sinus which Caused Osteomyelitis of Frontal Bone:A case report

I．はじめに

　頭蓋骨の化膿性骨髄炎は，長管骨のそれに比べ，比較的稀な疾患である．さらに抗生剤の発達に伴い，その発生件数は減少しmortality,morbidityも著しく改善されてきてはいるが，ひとたび骨髄炎を起こすと硬膜下・外膿瘍，脳膿瘍や敗血症など重篤な合併症を引き起こし得るので，臨床的に重要な疾患であるのは変わらない．われわれは最近，前頭洞に原発した扁平上皮癌が，二次的な前頭骨骨髄炎を起こした興味ある症例を経験した．

　このように前頭洞原発の扁平上皮癌が頭蓋骨骨髄炎を引き起こした例は見当たらないので報告する．

A case of the squamous cell carcimoma of the frontal sinus complicated with osteomyelitis of the frontal bone was reported. A 47-year-old male was admitt-ed to Asahikawa Medical College Hospital because of a buldging of forehead and remittent fever of a six-month history and general convulsive seizures on the day before admission.

On physical examination, a buldging of forehead with redness, tenderness and fluctuation was noted. Sense of smell diminished bilaterally. Oto-laryngolo-gical examination disclosed paranasal sinusitis. Skull X-P and CT scan suggested osteomyelitis of the frontal bone secondary to frontal sinusitis.