頭皮熱傷瘢痕癌7例の検討

Surgical Management of Squamous-Cell Carcinomas Arising in Burn Scar of the Scalp

I．はじめに

　Marjolinによる詳細な報告^10）以来，瘢痕組織を発生母地とする悪性腫瘍はMarjolin ulcerと呼ばれて予後不良であり^18），とりわけ頭皮瘢痕に発生した有棘細胞癌は頭蓋骨や脳組織へ浸潤するため，治療が困難である^{4,6,11，14,16,18）}．

　私たちはこれまでに頭皮熱傷瘢痕癌の7例を経験しているので，特徴的臨床像，治療および予後について検討して報告する．

A series of seven patients with squamous-cell carci-noma that arose in the area of an old scalp burn is pre-sented, and the patients' profiles, surgical procedures and results are reviewed. In six patients, burn scar of the scalp caused by direct exposure to fire in their in-fancy was a pathogenesis underlying the development of the malignancy, and the time interval was estimated to be an averge of 53 years. In five patients there was evidence of intracranial invasion of the carcinoma in-volving the dura mater and cerebral parenchyma, as re-vealed by neuroradiological examinations and surgery.