鼻腔悪性黒色腫の1症例とその剖検所見

A CACE OF MALIGNANT MELANOMA OF THE NOSE AND PARANASAL SINUSES WITH ITS AUTOPSIC FINDINGS

I．はじめに

　鼻腔および副鼻腔に原発する悪性黒色腫の報告は，Grace^1）によると1869年にLückeにより第1例が行なわれ，本邦においては1918年にはじめて穂積によつて報告されて（光吉^2）による）以来しばしば発表されているが，本腫瘍は他の悪性腫瘍に比しその報告例は比較的まれであり，また予後不良とされているわりにはその剖検報告例が少ない。私どもは最近左側鼻腔に発生した悪性黒色腫の患者に遭遇し，あらゆる治療の効もなく急速に全身転移をきたし不幸な転帰をとつた症例を経験し，かつその剖検所見をえたのでここに報告すると同時に，本症に関する本邦文献の統計的観察をもあわせて行なつたので報告する。

　A case of malignant melanoma of the nasal and paranasal sinuses appeared in a male adult of 66 years old is reported.

　The patient has complained of left nasal obstruction and recurrent nasal bleeding since approximately 1 year prior to the first visit to our clinic.

　Histopathological examination of the biopsy revealed a malignant melanoma. Inspite of the surgical and radiation therapy combined with chemotherapy, he died of generalized metastasis with melanoma about 3 months after the surgery.

　Findings of its autopsy showed the generalized metastatic dissemination which might be caused by the circulation system.

　On the basis of the statistical observation reviewed from japanese literature the authers have concluded that the histopathological and histochemical examinations were absolutely necessary for its early diagnosis because of its extremely poor prognosis.