上咽頭腺房細胞癌の1例

ACINIC CELL CARCINOMA OF THE EPIPHARYNX

　I．はじめに

　頭頸部領域に発生する悪性腫瘍のうち，腺系腫瘍の占める割合は，大唾液腺を除いては少なく，その中では口腔，鼻・副鼻腔，中咽頭のものが主であり，喉頭や上・下咽頭に，腺系腫瘍が発生することは稀である。これらの腫瘍は放射線治療に対する感受性が低く，化学療法も著効を示すことは少ないので，その治療は手術的方法が主となる。しかしながら，発生部位によつては腫瘍とその周囲組織を含めた広範囲切除が困難な場合もあり，治療上の問題となることが少なくない。

　腺房細胞癌は唾液腺型悪性腫瘍の中でも稀なものであつて，その大部分は耳下腺に発生しており，小唾液腺由来と考えられるものはきわめて少ない。最近，われわれは上咽頭にみられた腺房細胞癌の1例を経験したので報告するとともに，頭頸部領域の小唾液腺腫瘍，とくに小唾液腺腺房細胞癌について文献的考察を行なう。

　A case of acinic cell carcinoma of the epipharynx is reported. The patient, a female, aged 45, complained of nasal obstruction and intermittent otalgia for the last 7 months. Under a direct endoscopic examination, the epipharyngeal space was found to be completely filled with a tumor mass. There was no evidence of ulceration. And, the cervical lymph nodes were not enlarged.

　The tumor was surgically removed by means of transpalatal approach. The tumor tissues were examined histologically with light- as well as electronmicroscopes; immunohistochemical studies were also undertaken. The tumor was diagnosed as an acinic cell carcinoma.

　According to our study only thirteen cases of acinic cell carcinoma of the minor salivary glands were found in the literature. The most of them appeared to have occurred in the oral cavity. We believe that this is the first case in which acinic cell carcinoma had occurred in the epipharyngeal region.