脳に著明な多発性腫瘍塞栓を認めた中咽頭癌脳転移の1例

Multiple Cerebral Infarction by Blood-borne Tumor Emboli in Carcinoma of the Mid-pharynx:An autopsy case

I．はじめに

　悪性腫瘍の腫瘍塞栓子（以後tumor emboli）の存在は，よく知られた事実であるが^2.12.14），臨床上，tumoremboliを原因とする脳血管障害，胆の脳転移の報告例は少ない^4）．今回，われわれは，原発癌の照射後，突然の多彩な脳神経症状で発症した中咽頭癌の脳転移で，剖検にて原発癌に山来する多発性腫瘍塞栓を脳血管内に認めた症例を経験したので報告する．

In May, 1989, a-54-year old man was admitted com-plaining of sore throat and tumor of the neck which had persisted for 2 months. Mid-pharyngeal tumor was diagnosed as poorly differentiated squamous cell carcinoma (stage, T₃N₂M₀) and the patient was treated with radiation (Co 65Gy) from May 30 to July 24 and chemotherapy (UFT), which therapies were effective. On Aug. 16, sudden onset of-consciousness disturbance and hemiparesis was revealed, and MRI showed small cerebral infarction. He died on Oct. 23, of pneumonia. Pathological diagnosis revealed a case of carcinoma of the mid-pharynx with wide-spead tumor embolism. Mul-tiple cerebral and myocardial infarctions, thrombus in pulmonary arteries and congestion of kidneys with tumor emboli, clue to “disseminated intravascular carci-nomatosis” were noticed. A direct cause of death was dyspnea clue to multiple lung metastases, pneumonia and tumor embolism in the pulmonary and coronary arteries.