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Ⅰ.はじめに
副鼻腔に原発する悪性黒色腫は,極めて予後不良である11).その解剖学的構造から手術侵襲は大きく,根治性やQOLにおける問題がある.また,高齢者の悪性腫瘍は従来積極的に治療されることはなく,経過観察されることが多い.今回われわれは,高齢者の頭蓋外に存在する副鼻腔悪性黒色腫に対しガンマナイフ治療を行い,著明な腫瘍縮小および,QOL改善が得られた1例を経験したので文献的考察を加え報告する.
A case of malignant melanoma in the paranasal sinuses, successfully treated with gamma knife stereotactic radio-surgery, is reported. A 90-year-old man with left periorbital swelling was referred to our hospital for gamma knife ra-diosurgery. He had a 4-month history of left periorbital swelling and ophthalmalgia, but he was treated conservatively due to his age. CT showed a large mass with bone destruction located in the nasal cavity, paranasal si-nuses, and orbita. A 15 Gy peripheral dose was administered to the upper portion of the tumor with the gamma knife technique, at the 50% isodose line using a 18 mm collimator (21 shots).
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