頭蓋内に進展したGlomus Jugulare Tumorの1例

GLOMUS JUGULARE TUMOR THAT INVADED THE CRANIAL CAVITY

　I．はじめに

　Guildは1941年に人の側頭骨の中に頸動脈毬と同様な組織を発見しGlomus jugularisと名付けた。そして1945年にRosenwasser^1）によりGlomusjugularisより発生した腫瘍，すなわちGlomus jugulare tumorがはじめて報告されて以来，1959年にはAlford^2）らが316例の本腫瘍について考察を発表，さらにSchermer^3）らは1966年にAlfordの発表以後に報告された85例についての考察を発表するなど，外国ではGlomus jugulare tumorは比較的しばしば報告されている。しかしわが国では1956年に切替，鳥山（寧）^4）により第1例が報告されたが，その後中村ら^5）による1例，再び切替ら^6）による1例と3例の詳細な発表を含め，その報告は現在なお12例に過ぎぬきわめて稀な疾患である。

　私たちも頭蓋内に進展し，不幸な転帰をとつた本腫瘍の1症例を経験し，剖検所見も得られたので報告する。

　The result of the post mortem examination of the glomus jugulare tumor is reported.

　A housewife, aged 48, complained of tinnitus of the left ear of 12 year standing, impairement of hearin of and aural discharge of the same ear. Previously, a diagnosis of otitis media was made and the left ear was operated upon. There was no improvement of the symptoms. Following this operation the ear became affected with granulation formation which required repeated scrapings.

　Since 2 years ago the patient developed occassional attacks of severe headaches with nausea. And since 1 month ago the vision of the right eye began to fail.

　The examination showed a faintly pinkish colored tumor in the external canal of the left ear. Microscopic examination showed the tumor to be a glomus jugulare.

　The head operation was performed only to find the tumor to be spreading into the base of the skull which precluded a complete removal. Seven days after this operation the patient died.

　The post mortem examination showed the tumor to be spreading into the occipital and middle cranial fossae, as well as, the middle ear cavity and parietal bone including the mastoid cavity. However, there was no evidence that the brain tissue having been invaded by metastatic growths.