右上顎洞に発生した横紋筋肉腫の1剖検例

RHABDOMYOSARCOMA OF THE MAXILLARY SINUS,AN AUTOPSY CNSE REPORT

　I．はじめに

　横紋筋肉腫は，軟部組織の悪性腫瘍としては脂肪肉腫や線維肉腫についで多く，きわめて悪性度が高い腫瘍として知られている。好発部位は，四肢の骨格筋や泌尿性器で，耳鼻咽喉科領域における報告は非常に少ない。最近われわれは，鼻閉塞，頬部腫脹を主訴とし，右上顎に原発した横紋筋肉腫の1剖検例を経験したので報告する。

　An autopsy case with rhabdomyosarcoma of the right maxillary sinus, in a male, aged 56, is reported. The patient's chief complaints were sudden swelling of the right maxillary region and nasal obstruction with frequent epistaxis which repeatedly continued for the last 10 years. Examination showed the both nasal cavities to be obstructed with polipoid tumors.

　Radical maxillectomy and nasal polypectomy were performed. Microscopic examination of the surgically resected spesimens revealed the contents to be composed mainly of the spindle shaped atypical cells. The patient was treated postoperatively by means of irradiation and chemotherapy. But, he died 11 years after the onset of his initial symptoms.

　At autopsy, the right maxillary sinus was found to be filled with grayish-white necrotic tumor mass which was metastasized to the left epipharyngeal region, left lung, tonsils and cervical lymph nodes.

　Histologically, the tumor was diagnosed as pleomorphic rhabdomyosarcoma.